Single-site intracorporeal purse-string stitching versus single-port extracorporeal knotting for laparoscopic inguinal inner ring closure in children: a comparative study

Abstract

Objective To compare the surgical and functional outcomes of single-site (transumbilical two-port) intracorporeal purse-suturing (IP) and single-port extracorporeal knotting (EK) for laparoscopic pediatric inguinal hernia (PIH) repair. Methods Between June 2008 and December 2014, 358 PIH children underwent laparoscopic inguinal herniorrhaphy, including 126 treated by single-site intracorporeal purse string stitching using a needle-holder (IP group), and 232 by single-port extracorporeal knotting using an inner two-hook needle with preperitoneal hydrodissection (EK group). Results In all patients laparoscopic procedures were completed successfully without conversion. The operating time in IP group was significantly longer than that in EK group [unilateral: (20.4±2.1) min vs. (9.4±1.3) min, t=-5.23, P 0.05]. Five cases had intraoperative hematoma in the IP group while none in the EK group. One each suffered from recurrence in IP group and EK group. Three postoperative hydroceles were seen in IP group and one in EK group. Subcutaneous knot granulomas were seen in two in EK group. Conclusions Both IP and EK laparoscopic procedures are safe and feasible. With the assistance of preperitoneal hydrodissection technique, single-port laparoscopic EK herniorraphy is superior to single-site IP repair in easy performance and shorter operation time. Key words: Hernia, inguinal; Herniorrhaphy; Laparoscopes