COMBINED HERNIAS OF THE ABDOMINAL WALL IN CHILDREN - SCARLESS SYNCHRONOUS LAPAROSCOPIC SURGERY dr.aleksmaksymenko@gmail.com

 

COMBINED HERNIAS OF THE ABDOMINAL WALL IN CHILDREN - SCARLESS SYNCHRONOUS LAPAROSCOPIC SURGERY

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Ukraine

Oral only

Aim: To investigate the effectiveness of laparoscopic treatment of combined defects of the abdominal wall in children.

A retrospective study of laparoscopic repair of combined defects of the abdominal wall was performed in 17 children, using a single-port technique in 13 cases and a two-port technique in 4 others. Inguinal hernias were closed by a double percutaneous internal ring suturing (PIRS) technique and epigastric hernias by the same approach. The average age of patients was 1.8 ± 0.4 years. Thirteen patients had a bilateral inguinal hernia and an umbilical hernia. Four children had four combined defects: epigastric hernia, umbilical hernia, and bilateral inguinal hernia. Five patients had metachronous inguinal hernia.

The duration of the surgery varied from 22 to 57 min, the mean operative duration was 29 ± 3.4 minutes. All patients received a multimodal anesthetic approach and were treated as day cases with no intra or post-operative complications. At follow up there were no recurrent hernias and the scar in the left lateral area is almost imperceptible, the umbilicus looks like a real embryonic scar.

The advantages of simultaneous laparoscopic management of combined defects of the abdominal wall in children are excellent visual control, evaluation of the contralateral inguinal ring and eliminating its defect when detected, reducing the time of surgical intervention, and good economic results. The proposed laparoscopic technique can be the method of choice to diagnose and manage combined abdominal wall hernias in children as a day-case procedure, producing an ideal cosmetic result without complications