Transumbilical Laparoscopic Hernioplasty In Treatment Of Patent Processus Vaginalis In Infants And Children

Objective:To discuss the application of transumbilical laparoscopic hernioplasty in the treatment of patent processus vaginalis in infants and children.Methods:From March 2014 to December 2015,402 infants or children(male 352,female 50)with patent processus vaginalis(562 sides)undergone transumbilical laparoscopic high ligation of hernia sac by using a epidural needle in our hospital.The patients' age range from 1 to 14 years old,mean age was 5.7 years old.There were 242 cases on the right side,132 cases on the left side and 28 bilateral,including three cases funicular hydrocele and two cases complicated with uterine round ligament cyst.Of them,two cases had recurrent hernia and two cases had incarcerated hernia.Loop of 7-0 silk suture and polyester braided suture were guided into peritoneal cavity through extraperitoneal space by a epidural needle under the surveillance of micro-laparoscopy via transumbilical double-port in male and single-port in female.Then high ligation of the hernia sac was performed.Review 402 cases undergoing transumbilical laparoscopic ligation(transumbilical group)between March 2014 to December 2015,34 cases receiving normal double-port laparoscopic ligation(normal group)between November 2013 to March 2014.Compare the average operation time of two groups,even the subgroups.Results:The operation was successfully completed in all of the cases except for three cases sliding hernia.152 cases of contralateral patent processus vaginalis(CPPV)and one direct hernia were found.The operation time ranged from 5 to 12 min in unilateral cases,and 8 to 15 min in bilateral cases.All patients were successfully followed up 1 to 23 months.The results showed that epiplocele from the stab in one case(0.25%),knot inflammatory rejection in one case(0.25%)and recurrent hernia in one case(0.25%).In terms of operation time,the results shown significantly difference between male and female groups,significantly difference between the female cases of two groups,no statistically difference between the male cases of two groups.Conclusions:Transumbilical laparoscopic high ligation of hernia sac is safe and effective for infant and children with patent processus vaginalis.The operation method is easy to study,and more perfect incision than normal double port laparoscopic hernioplasty.It is worthy to be popularized in clinlic.