Laparoscopic Percutaneous Extraperitoneal Closure Research Articles

Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions

Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions

P-224 Laparoscopic percutaneous extraperitoneal closure for the treatment of 3 children with recurrent inguinal hernia(Poster Session Operative procedure,Better Life for Sick Children, Better Future for Pediatric Surgery,the 45th Annual Meeting of Japanese Society of Pediatric Surgeons)

P-224 Laparoscopic percutaneous extraperitoneal closure for the treatment of 3 children with recurrent inguinal hernia(Poster Session Operative procedure,Better Life for Sick Children, Better Future for Pediatric Surgery,the 45th Annual Meeting of Japanese Society of Pediatric Surgeons)

P-164A 小児腹腔鏡下鼠径ヘルニア修復術(LPEC法)症例における対側腹膜鞘状突起開存率と予防的閉鎖の適応について(結腸・鼠径ヘルニア, 第44回日本小児外科学会学術集会)

P-164A 小児腹腔鏡下鼠径ヘルニア修復術(LPEC法)症例における対側腹膜鞘状突起開存率と予防的閉鎖の適応について(結腸・鼠径ヘルニア, 第44回日本小児外科学会学術集会)

P-163A Complications associated with laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia in children(Gastrointestinal/Inguinal hernia, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons)

P-163A Complications associated with laparoscopic percutaneous extraperitoneal closure (LPEC) for inguinal hernia in children(Gastrointestinal/Inguinal hernia, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons)

P-162A Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children(Gastrointestinal/Inguinal hernia, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons)

P-162A Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children(Gastrointestinal/Inguinal hernia, the 44th Annual Meeting of Japanese Society of Pediatric Surgeons)

Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions

Background/Purpose In 1995, we developed laparoscopic percutaneous extraperitoneal closure (LPEC) to treat inguinal hernias in children. This study evaluated LPEC's safety, efficacy, and reliability in 3 hospitals. Methods In 2 hospitals, LPEC was the standard procedure used to repair inguinal hernias in children, and in 1 hospital, it was done optionally in girls. During LPEC, a 4.5-mm laparoscope was placed through an umbilical incision, a 2-mm grasping forceps was inserted on the left side of the umbilicus, and a 19-gauge LPEC needle with suture material was inserted at the midpoint of the right or left inguinal line. The hernial sac orifice was closed extraperitoneally by circuit suturing around the internal inguinal ring using the LPEC needle. Results Nine hundred seventy-two LPECs were performed on 711 children (age range, 18 days to 19 years): 384 boys had 500 internal inguinal rings closed and 327 girls had 472 internal inguinal rings closed. Operating time for uni- or bilateral inguinal hernias ranged from 10 to 30 minutes. No complications occurred during surgery. The recurrence rate was 0.73% during follow-up (range, 5 months to 10 years). No hydroceles or testicular atrophy occurred after surgery. Conclusion Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children appears to be safe, effective, and reliable.

Laparoscopic percutaneous extraperitoneal closure (LPEC) method for the exploration and treatment of inguinal hernia in girls

We recently introduced the laparoscopic percutaneous extraperitoneal closure (LPEC) method for the treatment of girls with inguinal hernia. Using the LPEC method, 129 girls underwent laparoscopic herniorrhaphy. A 5 mm laparoscope was inserted via the umbilicus. A 3 mm "snake retractor" was advanced through the lateral abdominal wall to measure the length of the hernia sac and contralateral patent processus vaginalis (PPV), respectively. The hernia sac and PPV were closed at the level of the internal inguinal ring with a 2-0 non-absorbable purse-string suture using Lapaherclosure, a special 19G needle that can hold a suture at the tip. The length of the hernial sac was significantly longer than that of contralateral PPV (mean 41 mm; range 18-70 mm; P < 0.05). There were no serious complications associated with the procedure. No recurrence of hernia or metachronous contralateral hernia has been identified so far. This approach enables us to perform contralateral exploration without any additional techniques, followed by immediate and accurate closure of the hernia sac and PPV. We conclude that the LPEC method is a safe and efficacious procedure with a low recurrence rate that should be viewed as an acceptable alternative to the traditional open approach.