Skip to main content
Log in

Modified single-port minilaparoscopic extraperitoneal repair for pediatric hydrocele: a single-center experience with 279 surgeries

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of the study is to introduce our experience of a modified single-port minilaparoscopic technique for the treatment of pediatric hydrocele.

Methods

Between June 2008 and May 2012, 279 boys (115 communicating hydrocele and 164 “non-communicating” hydrocele, diagnosis based on preoperative physical examination and scrotal ultrasound) underwent the modified single-port minilaparoscopic repair in our institution. During surgery, a 3-mm laparoscope was inserted into the abdomen through a mini-umbilical incision. The hydrocele sac orifice was closed by an extraperitoneal purse-string suture placed around the internal ring with an ordinary taper needle and an endoclose needle.

Results

Of all the 279 patients, 16 (5.7 %) were found to have a potential patent processus vaginalis (PPV) on the contralateral side. Of the 164 boys diagnosed with “non-communicating” hydrocele preoperatively, 5 (3.0 %) had no PPV identified in laparoscope and the other 159 (97.0 %) had PPV actually. A total of 274 single-port minilaparoscopic procedures were performed, and all cases were successful without serious complications. The mean operative time was 19.5 and 24.8 min for unilateral and bilateral operations, respectively. Postoperative complications were noted in 4 cases, 2 (0.7 %) patients with scrotal edema, 1 (0.4 %) patient experienced an umbilical hernia, and 1 (0.4 %) patient with suture site abscess. During a median follow-up period of 9 months (range 6–24 months), postoperative hydrocele recurrence was seen in 2 patients (0.7 %).

Conclusions

This modified single-port minilaparoscopic technique is a safe, effective, and reliable procedure for pediatric hydroceles.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Drew JH, Parkinson P, Walstab JE et al (1977) Incidences and types of malformations in newborn infants. Med J Aust 1:945

    CAS  PubMed  Google Scholar 

  2. Osifo OD, Osaigbovo EO (2008) Congenital hydrocele: prevalence and outcome among male children who underwent neonatal circumcision in Benin City, Nigeria. J Pediatr Urol 43:178–182

    Article  Google Scholar 

  3. Marden PM, Smith DW, McDonald MJ (1964) Congenital anomalies in the newborn infant, including minor variations. A study of 4,412 babies by surface examination for anomalies and buccal smear for sex chromatin. J Pediatr Urol 64:357–371

    Article  CAS  Google Scholar 

  4. Jason M, Wilson David S et al (2008) Hydrocele in the pediatric patient: inguinal or scrotal approach? J Urol 180:1724–1728

    Article  Google Scholar 

  5. Partrick DA, Bensard DD, Karrer FM et al (1998) Is routine pathological evaluation of pediatric hernia sacs justified? J Pediatr Surg 33:1090–1094

    Article  CAS  PubMed  Google Scholar 

  6. Steigman CK, Sotelo-Avila C, Weber TR (1999) The incidence of spermatic cord structures in inguinal hernia sacs from male children. Am J Surg Pathol 23:880

    Article  CAS  PubMed  Google Scholar 

  7. Cam C, Celik C, Sancak A et al (2009) Inguinal herniorrhaphy in childhood may result in tubal damage and future infertility. Arch Gynecol Obstet 279:175–176

    Article  PubMed  Google Scholar 

  8. Schier F (2006) Laparoscopic inguinal hernia repair: a prospective personal series of 542 children. J Pediatr Surg 41:1081–1084

    Article  PubMed  Google Scholar 

  9. Bharathi RS, Arora M, Baskaran V (2008) Minimal access surgery of pediatric inguinal hernias: a review. Surg Endosc 22:1751–1762

    Article  Google Scholar 

  10. Schier F, Montupet P, Esposito C (2002) Laparoscopic inguinal herniorrhaphy in children: a three-center experience with 933 repairs. J Pediatr Surg 37:395–397

    Article  PubMed  Google Scholar 

  11. Takehara H, Yakabe S, Kameoka K (2006) Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions. J Pediatr Surg 41:1999–2003

    Article  PubMed  Google Scholar 

  12. Janetschek G, Reissigl A, Bartsch G (1994) Laparoscopic repair of pediatric hydroceles. J Endourol 8:415–417

    Article  CAS  PubMed  Google Scholar 

  13. Koski ME, Makari JH, Adams MC et al (2010) Infant communicating hydroceles-do they need immediate repair or might some clinically resolve? J Pediatr Surg 45:590–593

    Article  PubMed  Google Scholar 

  14. Naji H, Ingolfsson I, Isacson D et al (2012) Decision making in the management of hydroceles in infants and children. Eur J Pediatr 171:807–810

    Article  PubMed  Google Scholar 

  15. Hall NJ, Ron O, Eaton S, Pierro A (2011) Surgery for hydrocele in children-an avoidable excess? J Pediatr Surg 46:2401–2405

    Article  PubMed  Google Scholar 

  16. Fried AH, Epstein MH (1994) Childhood hydrocephalus: clinical features, treatment, and the slit-ventricle syndrome. Neurosurg Q 4:51–65

    Article  Google Scholar 

  17. Kapur P, Caty MG, Glick PL (1998) Pediatric hernias and hydroceles. Pediatr Clin North Am 45:773–789

    Article  CAS  PubMed  Google Scholar 

  18. Sweeney DD, Smaldone MC, Docimo SG (2007) Minimally invasive surgery for urologic disease in children. Nat Clin Pract Urol 4:26–38

    Article  PubMed  Google Scholar 

  19. Jahnson S, Sandblom D, Holmäng S (2011) A randomized trial comparing 2 doses of polidocanol sclerotherapy for hydrocele or spermatocele. J Urol 186:1319–1323

    Article  CAS  PubMed  Google Scholar 

  20. Agbakwuru EA, Salako AA, Olajide AO et al (2008) Hydrocelectomy under local anaesthesia in a Nigerian adult population. Afr Health Sci 8:160–162

    CAS  PubMed Central  PubMed  Google Scholar 

  21. Endo M, Watanabe T, Nakano M et al (2009) Laparoscopic completely extraperitoneal repair of inguinal hernia in children: a single-institute experience with 1,257 repairs compared with cut-down herniorrhaphy. Surg Endosc 23:1706–1712

    Article  PubMed Central  PubMed  Google Scholar 

  22. Ron O, Eaton S, Pierro A (2007) Systematic review of the risk of developing a metachronous contralateral inguinal hernia in children. Br J Surg 94:804–811

    Article  CAS  PubMed  Google Scholar 

  23. Wang D, Qiu J, Fang Y et al (2011) Laparoscopic extraperitoneal repair of symptomatic hydrocele in children: a single-center experience with 73 surgeries. J Endourol 25:1221–1225

    Article  CAS  PubMed  Google Scholar 

  24. Wulkan ML, Wiener ES, VanBalen N et al (1996) Laparoscopy through the open ipsilateral sac to evaluate presence of contralateral hernia. J Pediatr Surg 31:1174–1177

    Article  CAS  PubMed  Google Scholar 

  25. Misra MC, Kumar S, Bansal VK (2008) Total extraperitoneal (TEP) mesh repair of inguinal hernia in the developing world: comparison of low-cost indigenous balloon dissection versus direct telescopic dissection: a prospective randomized controlled study. Surg Endosc 22:1947–1958

    Article  PubMed  Google Scholar 

  26. Choi YY, Kim Z, Hur KY (2011) Swelling after laparoscopic total extraperitoneal repair of inguinal hernias: review of one surgeon’s experience in 1,065 cases. World J Surg 35:43–46

    Article  PubMed  Google Scholar 

  27. Schier F, Turial S, Hückstädt T et al (2008) Laparoscopic inguinal hernia repair does not impair testicular perfusion. J Pediatr Surg 43:131–135

    Article  PubMed  Google Scholar 

  28. Ridgway PF, Shah J, Darzi AW (2002) Male genital tract injuries after contemporary inguinal hernia repair. BJU Int 90:272–276

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Mr. Weizhao Zhou for his assistance in the drawing of schematic illustration.

Conflict of interest

No competing financial interests exist.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zexuan Su.

Additional information

Zhifeng Wang and Le Xu contributed equally to this study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 1006 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, Z., Xu, L., Chen, Z. et al. Modified single-port minilaparoscopic extraperitoneal repair for pediatric hydrocele: a single-center experience with 279 surgeries. World J Urol 32, 1613–1618 (2014). https://doi.org/10.1007/s00345-014-1259-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-014-1259-8

Keywords

Navigation