Department of Pediatric Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea.
Department of Pediatric Surgery, Keimyung University Dongsan Medical Center, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601, Republic of Korea.
Surg Endosc. 2022 Feb;36(2):1320-1325. doi: 10.1007/s00464-021-08408-y. Epub 2021 Feb 24.
Laparoscopic repair is widely performed for the management of pediatric inguinal hernia (PIH), and different laparoscopic surgical methods are used. Herein, we present the application of laparoscopic totally extraperitoneal ligation (TEPL), which is a novel surgical method for PIH repair and is similar to traditional high ligation.
In this study, 103 pediatric patients underwent laparoscopic TEPL for inguinal hernia. Data including demographic characteristics, clinical presentation, time of surgery, length of hospital stay, and postoperative complications were analyzed retrospectively.
The patient's median age at surgery was 4.3 years, and the median body weight at surgery was 18 kg. The preoperative diagnoses were as follows: n = 53, right inguinal hernia; n = 45, left inguinal hernia; and n = 5, bilateral inguinal hernia. All patients were discharged on the day of surgery. The operative times were 27.2 min for unilateral inguinal hernia and 28.8 min for bilateral inguinal hernia. All patients, except one who had scrotal bruise, did not present with postoperative complications.
Laparoscopic TEPL, which is similar to traditional high ligation, is used for the treatment of PIH. Moreover, it is safe, beneficial, and feasible. Double ligation is performed on the extraperitoneal space, and the assessment of contralateral patent processus vaginalis is not complex. However, further studies should be conducted to assess for long-term outcomes.
腹腔镜修复术被广泛应用于小儿腹股沟疝(PIH)的治疗,且使用了不同的腹腔镜手术方法。在此,我们介绍了腹腔镜完全腹膜外结扎术(TEPL)的应用,这是一种用于 PIH 修复的新型手术方法,与传统的高位结扎术相似。
本研究回顾性分析了 103 例接受腹腔镜 TEPL 治疗腹股沟疝的小儿患者的数据,包括人口统计学特征、临床表现、手术时间、住院时间和术后并发症。
患者手术时的中位年龄为 4.3 岁,手术时的中位体重为 18kg。术前诊断为:n=53,右侧腹股沟疝;n=45,左侧腹股沟疝;n=5,双侧腹股沟疝。所有患者均于手术当天出院。单侧腹股沟疝的手术时间为 27.2 分钟,双侧腹股沟疝的手术时间为 28.8 分钟。除 1 例出现阴囊血肿外,所有患者均未出现术后并发症。
与传统高位结扎术相似的腹腔镜 TEPL 被用于治疗 PIH。此外,它是安全、有益且可行的。在腹膜外空间进行双重结扎,对对侧未闭鞘突管的评估并不复杂。然而,仍需要进一步的研究来评估长期结果。