Single-site laparoscopic high ligation of the extraperitoneal hernia sac with an epidural needle for incarcerated ovarian hernia in infants

Xu Cui,Jian-Qin Zhang,Liu Chen,Chao-Ming Zhou,Yun-Jin Wang,Qi-Liang Zhang

doi:10.1186/s12893-022-01520-3

Abstract

BackgroundThe purpose of this study was to evaluate the safety and efficacy of single-site laparoscopic extraperitoneal hernia sac ligation with an epidural needle for incarcerated ovarian hernias in infants and young children.MethodsThe clinical data of 38 infants with incarcerated ovarian hernias who underwent single-site laparoscopic extradural needle extraperitoneal hernia sac ligation from January 2015 to January 2018 were retrospectively analysed.ResultsAll procedures were successfully performed using laparoscopy with no need for conversion to open surgery. The time of hospital stay was 1.30 ± 0.39 days. During hospitalization and follow-up, there were no complications, such as intestinal or bladder injury, abdominal wall vascular injury, ovarian atrophy, hernia recurrence or contralateral indirect hernia. However, three patients experienced complications, including two cases of poor healing of the umbilical incision and one case of suture granuloma.ConclusionsSingle-site laparoscopic high ligation of the extraperitoneal hernia sac with an epidural needle is a safe and feasible method for the treatment of incarcerated ovarian hernias in infants and young children. It has the advantages of minimal trauma, no scarring and good cosmetic effects.

Highlights

The purpose of this study was to evaluate the safety and efficacy of single-site laparoscopic extraperi‐ toneal hernia sac ligation with an epidural needle for incarcerated ovarian hernias in infants and young children
Patients were excluded from this study for the following reasons: (1) their general condition was poor, with a history of peritonitis and systemic poisoning symptoms or serious medical diseases such as cardiopulmonary dysfunction; (2) they had a history of abdominal surgery; (3) they had a recurrent inguinal hernia; (4) their incarcerated ovaries were necrotic and needed to be replaced by ovariectomy; or (5) they refused to consent to the operation or cooperate during the follow-up schedule
We explored the abdominal cavity: a small amount of clear ascites was found in the abdominal cavity, the ring of the affected inguinal canal was not closed, and the oviduct continued to the inguinal canal with slight oedema and hyperaemia (Fig. 1)

Summary

Introduction

The purpose of this study was to evaluate the safety and efficacy of single-site laparoscopic extraperi‐ toneal hernia sac ligation with an epidural needle for incarcerated ovarian hernias in infants and young children. An incarcerated inguinal hernia is formed by abdominal organs that cannot be returned after entering the hernia sac and remain in the hernia sac. It is the most common complication of inguinal hernia in children. If it is not handled in time, it can lead to ischaemia and necrosis of the hernia contents, resulting in serious consequences. A small evagination of the parietal peritoneum, called the canal of Nuck, accompanies the round ligament through the inguinal canal to the labium majorum [1]. Due to the small pelvic volume and the inclination of uterine accessories in female children, it is easy to approach the orifice, and the incidence of ovarian hernia is

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