Abstract：
OBJECTIVE: To present our technical modifications of single incision laparoscopic percutaneous extraperitoneal closure (SILPEC) of the internal inguinal ring (IIR) for pediatric inguinal hernia (PIH).
METHODS: The prospectively collected data of all children diagnosed with PIH undergoing SILPEC at our center from 2016 to 2023 were reviewed and divided into two groups for result comparison: Group A: before and Group B: after the implementation of full modifications. Our modifications included using a nonabsorbable monofilament suture, creating a peritoneal thermal injury at the internal inguinal ring (IIR), employing a cannula to ensure the suture at the IIR ligates only the peritoneum, and double ligation of the IIR in selected cases.
RESULTS: 1755 patients in group A and in group B (1 month to 14 years old) were enrolled. There were no significant differences regarding baseline patient characteristics between the two groups. At a median follow-up of 40 months, the rate of recurrent CIH and subcutaneous stitch granuloma (SSG) was 2.3% and 1.5% in group A vs. 0% and 0% in group B (p < 0.001). There were no hydroceles, no ascended or atrophic testis.
CONCLUSIONS: Our SILPEC technical modifications can achieve zero recurrence and zero SSG for PIH.
METHODS: The prospectively collected data of all children diagnosed with PIH undergoing SILPEC at our center from 2016 to 2023 were reviewed and divided into two groups for result comparison: Group A: before and Group B: after the implementation of full modifications. Our modifications included using a nonabsorbable monofilament suture, creating a peritoneal thermal injury at the internal inguinal ring (IIR), employing a cannula to ensure the suture at the IIR ligates only the peritoneum, and double ligation of the IIR in selected cases.
RESULTS: 1755 patients in group A and in group B (1 month to 14 years old) were enrolled. There were no significant differences regarding baseline patient characteristics between the two groups. At a median follow-up of 40 months, the rate of recurrent CIH and subcutaneous stitch granuloma (SSG) was 2.3% and 1.5% in group A vs. 0% and 0% in group B (p < 0.001). There were no hydroceles, no ascended or atrophic testis.
CONCLUSIONS: Our SILPEC technical modifications can achieve zero recurrence and zero SSG for PIH.
摘要：
目的：介绍我们对小儿腹股沟疝（PIH）单切口腹腔镜经皮腹膜外腹股沟环（IIR）闭合术（SILPEC）的技术改进。
方法：对2016年至2023年在我中心接受SILPEC的所有诊断为PIH的儿童进行前瞻性收集的数据进行回顾，并分为两组进行结果比较：A组：之前和B组：实施完全修改后。我们的修改包括使用不可吸收的单丝缝合线，在腹股沟内环（IIR）造成腹膜热损伤，使用套管确保IIR处的缝合线仅连接腹膜，在选定的情况下进行IIR的双重结扎。
结果：纳入A组和B组（1个月至14岁）的1755例患者。两组之间的基线患者特征没有显着差异。中位随访40个月,A组的CIH和皮下缝合肉芽肿（SSG）的复发率分别为2.3％和1.5％。B组分别为0%和0%(p<0.001)。没有鞘膜积液,没有上升或萎缩的睾丸。
结论：我们的SILPEC技术修改可以实现PIH的零复发和零SSG。
方法：对2016年至2023年在我中心接受SILPEC的所有诊断为PIH的儿童进行前瞻性收集的数据进行回顾，并分为两组进行结果比较：A组：之前和B组：实施完全修改后。我们的修改包括使用不可吸收的单丝缝合线，在腹股沟内环（IIR）造成腹膜热损伤，使用套管确保IIR处的缝合线仅连接腹膜，在选定的情况下进行IIR的双重结扎。
结果：纳入A组和B组（1个月至14岁）的1755例患者。两组之间的基线患者特征没有显着差异。中位随访40个月,A组的CIH和皮下缝合肉芽肿（SSG）的复发率分别为2.3％和1.5％。B组分别为0%和0%(p<0.001)。没有鞘膜积液,没有上升或萎缩的睾丸。
结论：我们的SILPEC技术修改可以实现PIH的零复发和零SSG。
