Single-incision laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: an initial report

This report describes the first use of single-incision, two-port access for single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) to manage inguinal hernia in children. Between December 2009 and April 2010, 92 SILPECs of inguinal hernia and hydrocele were performed for 62 patients at Osaka City University Graduate School of Medicine. The SILPEC technique was performed using two ports (a 4.2-mm port placed using the open technique and an additional 4.2-mm port) inserted through the same periumbilical skin incision with different entrances through the abdominal wall. A 19-gauge LPEC needle (a special instrument with a wire loop at the tip to hold the material for circuit suturing around the internal inguinal ring) was used to close the orifice of the hernial sac extraperitoneally with circuit suturing around the internal inguinal ring. Data regarding patient demographics, type of hernia, operating time, complications, postoperative hospital stay, and recurrence were prospectively collected. The mean operative time was 26.9 min. The estimated blood loss was almost nil, and no intraoperative complications occurred. The use of SILPEC for inguinal hernia and hydrocele in children appears to be safe, effective, and reliable.