{Reference Type}: Journal Article
{Title}: 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.
{Author}: Son TN;Bao HV;Van NTH;Hiep PD;Mai DV;Quyet TV;
{Journal}: Pediatr Surg Int
{Volume}: 40
{Issue}: 1
{Year}: 2024 Jul 13
{Factor}: 2.003
{DOI}: 10.1007/s00383-024-05779-w
{Abstract}: <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.