Percutaneous Internal Ring Suturing for the Minimally Invasive Repair of Congenital Inguinal Hernia in Neonates: A Retrospective Cohort Study

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dc.contributor.authorThomas, David T.
dc.contributor.authorTulgar, Serkan
dc.date.accessioned2024-07-12T21:40:20Z
dc.date.available2024-07-12T21:40:20Z
dc.date.issued2023en_US
dc.department[Belirlenecek]en_US
dc.description.abstractIntroductionInguinal hernia (IH) repair is among the most frequently performed surgical operations in children. While open herniorrhaphy has been the gold standard surgical method of choice, the popularity of laparoscopic repair has sharply risen over the past two decades. Although a wide range of literature on the use of laparoscopy for IH repair in children exists, data regarding neonates, an especially delicate group of children, is limited to only a few studies. This study aims to evaluate the surgical, anaesthetic, and follow-up data of term neonates undergoing percutaneous internal ring suturing (PIRS) for IH repair in order to determine if it is a viable option for this specific patient population.Materials and methodsThis single-centre retrospective cohort included all children who underwent PIRS for IH repair during an 86 -month period between October 2015 and December 2022. Patients' gender, gestational age at birth, age and weight at surgery, side of IH at diagnosis, per-operative findings (presence of contralateral patent processus vaginalis (CPPV)), surgical time, time under anaesthesia, follow-up time, and follow-up findings were collected from an electronic database and analysed. The primary outcome measures were surgical time, rate of recurrence, and presence of CPPV and the secondary outcome measures were anaesthesia time and the rate of complications.ResultsDuring the study period, 34 neonates (23 male and 11 female) underwent laparoscopic repair for IH using the PIRS technique. Average age and weight at surgery were 25.2 +/- 3.2 (20-30) days and 3530.4 +/- 293.6 (3012 -3952) gm, respectively. IH was detected on the right side in 19 (55.9%), on the left side in 12 (35.3%), and bilaterally in three (8.8%) patients at their presenting physical examination. Nine patients (26.5%) were found to have CPPV perioperatively, which were all repaired simultaneously. The average surgical time was 20.3 +/- 4.5 minutes for unilateral and 25.8 +/- 4.0 minutes for bilateral IH repair (p<0.01). On the contrary, the average time under anaesthesia was 33.2 +/- 4.5 minutes for unilateral and 33.5 +/- 4.9 minutes for bilateral IH repair, but the difference was not statistically significant (p>0.05). No early postoperative complications were observed. The average follow-up time was 27.6 +/- 14.4 (range: 3-49) months. Recurrence was seen in one patient (2.9%) and umbilical incision granuloma was observed in two (5.9%) patients.ConclusionSurgical times, anaesthesia times, complication rates, recurrence rates, and rate of CPPV in neonates undergoing PIRS are similar to those in older children and comparable to those of open herniorrhaphy and other laparoscopic techniques. Despite the suspicion that the rate of CPPV would be higher in neonates, we found that it is similar to that in older children. We conclude that PIRS is a viable option for the minimally invasive repair of IH in neonates.en_US
dc.identifier.doi10.7759/cureus.36180
dc.identifier.issn2168-8184
dc.identifier.issue3en_US
dc.identifier.pmid37065331en_US
dc.identifier.urihttps://doi.org/10.7759/cureus.36180
dc.identifier.urihttps://hdl.handle.net/20.500.12415/7252
dc.identifier.volume15en_US
dc.identifier.wosWOS:000964189800020en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherSpringernatureen_US
dc.relation.ispartofCureus Journal of Medical Scienceen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmzKY05208
dc.subjectPercutaneous Internal Ring Suturingen_US
dc.subjectPediatricen_US
dc.subjectChilden_US
dc.subjectNeonateen_US
dc.subjectLaparoscopyen_US
dc.subjectHerniorrhaphyen_US
dc.subjectContralateral Patent Processus Vaginalisen_US
dc.subjectInguinal Herniaen_US
dc.titlePercutaneous Internal Ring Suturing for the Minimally Invasive Repair of Congenital Inguinal Hernia in Neonates: A Retrospective Cohort Studyen_US
dc.typeArticle
dspace.entity.typePublication

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