Comparative Analysis Of Single And Two-port Laparoscopic Treatment Of Pediatric Indirect Inguinal Hernia

Objective:The internal organs of the abdominal cavity protrude through the inguinal region to form a hernia.The children are prone to indirect inguinal,which is the common disease of the pediatric surgery.If the hernia is embedded,serious consequence will happen.The operation methods include traditional open surgery and laparoscopic treatment,which can be divided into three-port 、two-port and single-port according to the numbers of holes.To summarize the experience of single-port and two-port laparoscopic treatment of pediatric indirect inguinal hernia,and compare the related clinical parameters.Methods:From January 2015 to December 2016,78 cases of pediatric indirect inguinal hernia in Laiwu City People’s Hospital were enrolled in the retrospective study.The performance were all recoverable lump in the groin and without pain.Among these patients,42 cases underwent single-port laparoscopic repair.There were 39 cases of boy and 3cases of girl,with the ages 1 to 8.And 36 cases underwent two-port laparoscopic repair,with 34 cases of boy and 2cases of girl.The ages of them were 1 to 7.5.The clinical parameters of the two groups were compared.Results:The mean operation time and intraoperative blood loss in single-port group were obviously shorten.And there was statistically significant difference with two-port group.There was no significant difference in hospitalization time and postoperative complications(P>0.05).But 5 cases in single-port group were discovered with more inner ring folds and scars.And there were spermaduct and concomitant vessels in these folds.These cases were time consuming,and 2 cases were forced to add secondary clamp and convert to two-port.There were no complication occurred and no recurrence in both groups.Conclusion:Compared to two-port laparoscopic repair,single-port laparoscopic repair is effective in treatment of pediatric indirect inguinal hernia with less operation time and less intraoperative blood loss.But the hernia needle is difficult to pass the inner ring if the inner ring with more folds and deep.At the same time,it is easy to damage the vas deferens and vessels.In addition,it can cause the insufficiency of peritoneal ligation,which can increase the risk of recurrence.In the two-port laparoscopic repair group,the peritoneum can be lift by the auxiliary forceps if the inner ring with more folds and deep.The hernia needle can be more easily hidden under the peritoneum,which can effectively avoid the damage of blood vessels and vas deferens.In addition to this,the operation time can be shorten.So the two-port laparoscopic repair is necessary when inner ring with more folds and deep,in order to save operation time and less intraoperative trauma.