Modified percutaneous internal ring suturing with peritoneal injury in children: matched comparison to open hernia repair
- 1 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Surgical Endoscopy
- Vol. 35 (2), 854-859
- https://doi.org/10.1007/s00464-020-07457-z
Abstract
Background The aim of this study was to elucidate the outcomes of percutaneous internal ring suture (PIRS) technique for inguinal hernia repair augmented with thermal peritoneal injury compared to open inguinal hernia repair (OHR) in a large population of contemporary pediatric patients. Thermal injury with PIRS has been shown to reduce recurrence in animal models and is increasingly being incorporated into clinical practice. Methods Retrospective review of all PIRS procedures and OHR between Jan-2017 to Sept-2018 was performed. Data regarding patient characteristics, characteristics of the hernia, operative details, postoperative complications, and recurrence were collected. Non-parametric tests were used and p < 0.05 was regarded as statistically significant. 1:1 Propensity score matching was performed using "nearest-score" technique. Matching was done based on age, sex, follow-up time, side of hernia, repair of contralateral hernia, and number of additional procedures. Results 90 modified PIRS patients were matched to 90 OHRs. Patient demographics, hernia characteristics, and follow-up time were similar between the two groups after matching. There were no differences in recurrence rates (1 vs. 3 in OHR and PIRS, respectively, p = 0.6), complication rates (1 vs. 4 in OHR and PIRS, respectively, p = 0.4), and OR time [44.5 vs. 43 min in OHR and PIRS, respectively, p = 0.8]. There were no intraoperative complications for either technique. For OHR, laparoscopic look was performed in 23%. When successful, it revealed a contralateral PPV (patent processus vaginalis-PPV) in 41% of cases (9.4% of all OHR), all of which were repaired. For the PIRS procedures, a contralateral PPV was found in 25.6%, all of which were repaired. In the unmatched population, OHR had a metachronous hernia rate of 1.8%, none of whom had the contralateral PPV repaired at the original procedure. Conclusions PIRS with peritoneal injury has comparable efficacy and good safety compared to OHR. Recurrence and complication rates should further improve with increasing experience. Future studies should elucidate long term outcomes.This publication has 18 references indexed in Scilit:
- Does the Percutaneous Internal Ring Suturing Technique Impair Testicular Vascularization in Children Undergoing Inguinal Hernia Repair?Journal of Laparoendoscopic & Advanced Surgical Techniques, 2015
- Two Decades of History of Laparoscopic Pediatric Inguinal Hernia RepairJournal of Laparoendoscopic & Advanced Surgical Techniques, 2014
- Pediatric Laparoscopic Inguinal Hernia Repair: A Review of the Current EvidenceJournal of Laparoendoscopic & Advanced Surgical Techniques, 2014
- Technical Options of the Laparoscopic Pediatric Inguinal Hernia RepairJournal of Laparoendoscopic & Advanced Surgical Techniques, 2014
- Laparoscopic inguinal hernia repair in children using the percutaneous internal ring suturing technique – own experienceVideosurgery and Other Miniinvasive Techniques, 2014
- Stitch Versus Scar—Evaluation of Laparoscopic Pediatric Inguinal Hernia Repair: A Pilot Study in a Rabbit ModelJournal of Laparoendoscopic & Advanced Surgical Techniques, 2012
- Transcutaneous laparoscopic hernia repair in children: a prospective review of 275 hernia repairs with minimum 2-year follow-upSurgical Endoscopy, 2008
- Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: report of a new technique and early resultsSurgical Endoscopy, 2007
- Percutaneous Internal Ring Suturing: A Simple Minimally Invasive Technique for Inguinal Hernia Repair in ChildrenJournal of Laparoendoscopic & Advanced Surgical Techniques, 2006
- Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: a novel techniqueJournal of Pediatric Surgery, 2005