Laparoscopic Treatment of Inguinal Ovarian Hernia in Female Infants and Children: Standardizing the Technique.
infants
laparoscopy
ovarian hernia
ovary
technique
Journal
Journal of laparoendoscopic & advanced surgical techniques. Part A
ISSN: 1557-9034
Titre abrégé: J Laparoendosc Adv Surg Tech A
Pays: United States
ID NLM: 9706293
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
pubmed:
25
1
2019
medline:
14
6
2019
entrez:
25
1
2019
Statut:
ppublish
Résumé
Sliding indirect inguinal hernias containing ovary are not uncommon in girls. We reported our experience with laparoscopic treatment of inguinal ovarian hernias in female infants and children with the aim to standardize the surgical technique. The medical records of all girls who underwent laparoscopic inguinal hernia repair in our unit over the past 5 years were retrospectively reviewed. Only patients with an ovary found intraoperatively in the hernia sac were included in the study. All patients younger than 1 year received preoperatively a bowel preparation with simethicone and enemas. A total of 289 girls (median age 3.2 ± 0.5 years) underwent laparoscopic inguinal hernia repair during the study period. Thirty-seven patients (12.8%) had an ovarian hernia and were included in the study. Of these 37 girls, 9 (28.1%) were younger than 1 month, 20 (62.5%) ranged in age from 2 months to 1 year, and 3 (9.4%) were from 1 to 7 years. The average operative time was 23.7 minutes (range 18-43 minutes). No necrotic ovary was found intraoperatively, and all the procedures were accomplished laparoscopically. Neither intraoperative nor postoperative complications were reported. A patency of the contralateral canal of Nuck was found in 16 of the 37 patients (43.2%) and repaired during the same procedure. The average length of hospitalization was 21.8 hours (range 18-36 hours). No hernia recurrence or ovarian atrophy was recorded at a mean follow-up of 36 months (range 1-60 months). On the basis of our experience, laparoscopy should be considered the gold standard for the treatment of inguinal ovarian hernias in girls. Key points for standardization of the technique are as follows: bowel preparation in children younger than 1 year, use of 5-mm umbilical balloon trocar, correct positioning of 3-mm working screw trocars, section of the abnormal attachment of ovarian suspensory ligament, section of the periorificial peritoneum, and use of nonresorbable sutures.
Sections du résumé
BACKGROUND
BACKGROUND
Sliding indirect inguinal hernias containing ovary are not uncommon in girls. We reported our experience with laparoscopic treatment of inguinal ovarian hernias in female infants and children with the aim to standardize the surgical technique.
METHODS
METHODS
The medical records of all girls who underwent laparoscopic inguinal hernia repair in our unit over the past 5 years were retrospectively reviewed. Only patients with an ovary found intraoperatively in the hernia sac were included in the study. All patients younger than 1 year received preoperatively a bowel preparation with simethicone and enemas.
RESULTS
RESULTS
A total of 289 girls (median age 3.2 ± 0.5 years) underwent laparoscopic inguinal hernia repair during the study period. Thirty-seven patients (12.8%) had an ovarian hernia and were included in the study. Of these 37 girls, 9 (28.1%) were younger than 1 month, 20 (62.5%) ranged in age from 2 months to 1 year, and 3 (9.4%) were from 1 to 7 years. The average operative time was 23.7 minutes (range 18-43 minutes). No necrotic ovary was found intraoperatively, and all the procedures were accomplished laparoscopically. Neither intraoperative nor postoperative complications were reported. A patency of the contralateral canal of Nuck was found in 16 of the 37 patients (43.2%) and repaired during the same procedure. The average length of hospitalization was 21.8 hours (range 18-36 hours). No hernia recurrence or ovarian atrophy was recorded at a mean follow-up of 36 months (range 1-60 months).
CONCLUSIONS
CONCLUSIONS
On the basis of our experience, laparoscopy should be considered the gold standard for the treatment of inguinal ovarian hernias in girls. Key points for standardization of the technique are as follows: bowel preparation in children younger than 1 year, use of 5-mm umbilical balloon trocar, correct positioning of 3-mm working screw trocars, section of the abnormal attachment of ovarian suspensory ligament, section of the periorificial peritoneum, and use of nonresorbable sutures.
Identifiants
pubmed: 30676267
doi: 10.1089/lap.2018.0630
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM