%0 Journal Article
%T Modifications of surgical techniques in laparoscopic percutaneous extraperitoneal closure of inguinal ring for childhood inguinal hernia to achieve zero recurrence and zero subcutaneous stitch granuloma.
%A Son TN
%A Bao HV
%A Van NTH
%A Hiep PD
%A Mai DV
%A Quyet TV
%J Pediatr Surg Int
%V 40
%N 1
%D 2024 Jul 13
%M 39003422
%F 2.003
%R 10.1007/s00383-024-05779-w
%X <B>OBJECTIVE: </B>To present our technical modifications of single incision laparoscopic percutaneous extraperitoneal closure (SILPEC) of the internal inguinal ring (IIR) for pediatric inguinal hernia (PIH).<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>Our SILPEC technical modifications can achieve zero recurrence and zero SSG for PIH.