Two-port laparoscopy versus open high ligation for indirect inguinal hernia in children
- VernacularTitle:二孔法腹腔镜与开腹手术治疗小儿腹股沟斜疝的比较
- Author:
Yingmin ZHAO
;
Long LI
;
Jidong MA
- Publication Type:Journal Article
- Keywords:
Laparoscopic;
Indirect inguinal hernia;
Child
- From:
Chinese Journal of Minimally Invasive Surgery
2005;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare curative effects between laparoscopic and open surgery in the treatment of pediatric indirect inguinal hernia.Methods A group of 410 children with indirect inguinal hernia underwent micro-laparoscopic operation(Laparoscopic Group) from April 2001 to January 2006.This group was compared with another group of 408 children with indirect inguinal hernia,treated with open high ligation of the hernial sac(Open Group) from September 2004 to January 2006.In the Laparoscopic Group,a 5-mm trocar was inserted at the umbilicus for the exploration of bilateral internal rings.Another 5-mm trocar was inserted at the site slightly superior to the McBurney's point for introducing a needle holder.At the level of the neck of the hernial sac,the orifice of the vaginal process was circumferentially sutured and ligated.In the Open Group,high ligation of the hernial sac was conducted through a transversal incision at the external ring.Results The operations in the Laparoscopic Group were smoothly completed.The operative time for one side of hernia was significantly shorter in the Laparoscopic Group(33.4?9.6 min) than in the Open Group(38.0?7.6 min)(t=-7.596,P=0.000).In the Laparoscopic Group,no edema of the scrotum,subcutaneous hydrops,or infection occurred.The patients were followed for 1~55 months(mean,23.2 months).Short-term recurrence was observed in 3 children,who required a re-operation of laparoscopic repair.No testicular atrophy,iatrogenic retained testis,intestinal adhesion,or other long-term complications happened.In the Open Group,follow-up observations for 1~18 months(mean,10 months) revealed recurrence in 18 children,8 of whom were then cured with laparoscopic surgery and 10 of whom with open surgery.Iatrogenic retained testis happened in 9 children and a re-operation of open surgery was carried out.Conclusions Two-port laparoscopic high ligation of hernial sac for pediatric indirect inguinal hernia is minimally invasive,safe,and effective,but not suitable for children with cardiac insufficiency or newborn incarcerated hernia.
