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Corresponding Author

Ahmad Gamal

Document Type

Original Article

Abstract

Background : Using one instrument with a 2mm width was sufficient to invert the hernia sac in females with little trauma to the abdominal wall, hence excellent cosmoses. We introduce a new maneuver for congenital inguinal hernia (CIH) repair in female children using a 1.6-mm suture grasping device (SGD), a Snaring loop (SL), and an Epidural needle. We call this method telescopic inguinal hernia inversion and snaring in females of the pediatric age group.

Patients and methods : This study was carried out prospectively in the period from October 2022 to October 2023 on a total of fifty patients with hernia of the canal of Nuck who underwent telescopic inguinal hernia inversion and snaring under general endotracheal anesthesia. Abdominal and Inguinal ultrasound (US) was done on all patients to confirm the presence of the hernia sac and its size. All hernias were repaired using one SGD and one SL. The epidural needle was our tool to evaluate the diameter of the internal inguinal ring (IIR) laparoscopically. Period of the follow-up started from 1 week and lasted up to 6 months.

Results : Fifty patients, together with 60 hernia defects, comprised the material of this study with a mean age equaled 5.88 ± 2.7 years. IIR size ranged from 4 to 14 mm, with a mean of equaled 0.7 ± 0.29. The mean operative time was 26.78 ± 0.83 min in bilateral and 18.44 ± 2.22 min in unilateral cases. All operations were done without needing to convert to open operations or major intraoperative complications, and the period of follow-up ranged from 1 week to 6 months. Unnoticeable wound marks were reported in all patients, and no symptoms or signs were suggested of recurrence.

Conclusion : Needlescopic inguinal hernia inversion and snaring in females of the pediatric age group are feasible, simple, effective, and safe. This maneuver can be carried out in a short amount of time by almost all pediatric surgeons with standard laparoscopic handling, with the benefits of no recurrence or visible scars.

Keywords

Female inguinal hernia repair ; Inversion and snaring ; Needlescopy ; Suture grasping device ; Minimally invasive surgery

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