A comparative study on trans-umbilical single-port laparoscopic approach versus conventional repair for incarcerated inguinal hernia in children

Zhang Jun, Ge Juntao, Liu Shuli, Long Li, Zhang Jun, Ge Juntao, Liu Shuli, Long Li

Abstract

Purpose: The purpose of this study is to determine whether singleport laparoscopic repair (SLR) for incarcerated inguinal hernia in children is superior toconventional repair (CR) approaches.

Method: Between March 2013 and September 2013, 126 infants and children treatedwere retrospectively reviewed. All the patients were divided into three groups. Group A (48 patients) underwent trans-umbilical SLR, group B (36 patients) was subjected to trans-umbilical conventional two-port laparoscopic repair (TLR) while the conventional open surgery repair (COR) was performed in group C (42 patients). Data regarding the operating time, bleeding volume, post-operative hydrocele formation, testicular atrophy, cosmetic results, recurrence rate, and duration of hospital stay of the patients were collected.

Result: All the cases were completed successfully without conversion. The mean operative time for group A was 15 ± 3.9 min and 24 ± 7.2 min for unilateral hernia and bilateral hernia respectively, whereas for group B, it was 13 ± 6.7 min and 23 ± 9.2 min. The mean duration of surgery in group C was 35 ± 5.2 min for unilateral hernia. The recurrence rate was 0% in all the three groups. There were statistically significant differences in theoperating time, bleeding volume, post-operative hydrocele formation, cosmetic results and duration hospital stay between the three groups (P < 0.001). No statistically significant differences between SLR and TLR were observed except the more cosmetic result in SLR.

Conclusion: SLR is safe and effective, minimally invasive, and is a new technology worth promoting.

Keywords: Children; incarcerated inguinal hernia; single-port laparoscopy; surgical repair.

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
(a) Trocar (b) No-damage clamp (c) Operation port (d) Laparoscopic lens
Figure 2
Figure 2
(a) Intra-operative photograph showing a 3-year-old boy with incarcerated bowel (b) The incarcerated content is the momentum of 2-year-old girl (c) Intra-operative photograph to detect recessive contralateral hernia (d) The hernia contents pulled out
Figure 3
Figure 3
The high ligation of hernia sac was given
Figure 4
Figure 4
Left: Pre-operative picture; Right: Post-operative picture

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