Akademik Veri Yönetim Sistemi
Cocuk Cerrahisi Dergisi, cilt.19, sa.3, ss.111-116, 2005 (Scopus, TRDizin)
Aim: We present our results with laparoscopic high-ligation (LHL) in children with inguinal hernia or communicating hydrocele. Material and Method: The technique requires one infra-umbilical port for telescope, one 3.5mm laparoscopic forceps which is inserted into the abdominal cavity infraumbilically on the midline without trocar, and one special designed hook. Under laparoscopic vision, the hook is inserted through 2 mm skine incision at the level of internal inguinal ring and turned around the hernia sac preperitoneally. After high ligation is completed, infraumbilical fascia openning and skin incision are closed. The other 2-3mm incisions are closed with strip. Results: A total of 22 LHL have been performed in 19 patients (6 female, 11 male) with inguinal hernia or hydrocele. The mean age of the patients was 5 years (ranged between 2 monhs to 9.5 years). Contralateral hernia was diagnosed in two patients and fixed at the same session. Polydioxanone (PDS) was used in 8 and Nylon (Prolene) in 11 for high-ligation. The operating time ranged between 20 to 60 minutes (mean, 39.2 minutes) in unilateral cases and 55 minutes in the three bilateral cases. Subcutaneus emphysema developed in one patient which was minimal and resolved spontaneously. There was no peroperative complication in other cases. All patients were allowed for oral feeding 2 hours after operation and discharged from the hospital on the same or the next day. The follow up period was between 11 to 32 months (mean, 22.3 months); only one patient (%4.5) developed recurrent hernia 8 months after the operation in whom PDS was used for LHL, Conclusion: The technique has the advantage for exploration of contralateral internal ring and anterior abdominal wall. In our limited experience, the technique is easy to perform successfully without complication and there is one recurrence in long term follow up. We think that absorbable material for high ligation is an important factor in hernia recurrence.