Application of a Laparoscopic, Single-port, Double-needle Technique for Pediatric Hydroceles With Multiple Peritoneal Folds: A Trial From a Single-center 5-Year Experience

Abstract

To report our 5-year experience with a modified single-port, double-needle, minilaparoscopic technique for patent processus vaginalis with multiple peritoneal folds in the hydrocele sac orifice. A total of 125 consecutive cases of boys with unilateral pediatric hydrocele underwent minilaparoscopic repair between June 2008 and June 2013. The patients were divided into 2 groups. Group 1 consisted of 65 patients who underwent a 2-port laparoscopic procedure, during which a 3-mm grasping forceps was used to grasp the folds around the internal inguinal ring. Group 2 included 60 patients who received a modified single-port, double-needle, minilaparoscopic surgery. An Endo Close needle was used to spread the peritoneal folds and facilitate circular extraperitoneal suturing in group 2. The principal outcome factors were assessed between the groups. A total of 151 minilaparoscopic procedures were performed in 125 patients (age range, 12-68 months; median, 21.5 months). In total, 26 extra procedures were performed for simultaneous repair of a potential contralateral patent processus vaginalis. No significant difference in operation time was noted between group 1 and group 2 (25.9 ± 6.4 vs 27.1 ± 5.5 minutes). The procedures were performed successfully without serious preoperative complications. During a median follow-up period of 18 months (range, 6-36 months), no postoperative hydrocele recurrence was encountered. Our limited experience suggests that the modified single-port, double-needle, minilaparoscopic technique could be safe, effective, and more cosmetically appealing for the management of complicated pediatric hydroceles.