The Northeastern Society of Plastic Surgeons

Back to 2017 Program


Comparing Traditional Three Port and Single Site Laparoscopic Inguinal Hernia Repair in Children
Carmen Tong, DO1, Jason Van Batavia, MD2, David I. Chu, MD2, Arun Srinivasan, MD2.
1Einstein Medical Center, Philadelphia, PA, USA, 2Children's Hospital of Philadelphia, Philadelphia, PA, USA.

BACKGROUND: In the US, 4% of children are diagnosed with inguinal hernias. Laparoscopic herniorrhaphy has been considered comparable to the open technique. While traditional laparoscopic herniorrhaphy involves three separate skin incisions for ports, advancing technology has made single site (SS) laparoscopic herniorrhaphy possible. We thus sought to compare the safety and efficacy of traditional 3-port to SS laparoscopic herniorrhaphy.
METHODS: We retrospectively reviewed our IRB-approved registry for initial laparoscopic herniorrhaphies at our tertiary care center between 4/2013 and 10/2016. Surgeries were performed by a single surgeon using the peritoneal leaflet closure technique. All surgeries were performed using the 3-port approach until mid-2014 when the SS port system was adopted. Outcomes of operative success, operative duration, and complications were compared using univariable tests.
RESULTS: Of 67 children (63 boys) with median age 5.3 years (range 1.5-16.7), 3-port and SS laparoscopy were used in 23 (34%) and 44 (66%) children, respectively, including 5 children in the SS cohort who underwent bilateral herniorrhaphy. Operative success at a median follow-up of 3 months were 95.7% and 97.8%,respectively, for the 3-port and SS groups (p=1.0). Median operative durations were 74.5 and 73 minutes for the 3-port and SS groups, respectively (p=0.02). Postoperatively, the two groups had comparable postoperative complaints (0% in the 3-port and 13.6% in the SS) and intermediate-term complications: 1 boy (4%) in the 3-port group developed a contralateral hydrocele (despite a closed ring at surgery) and 1 boy (2%) in the SS group had a hernia recurrence from inguinal floor weakness requiring open modified Bassini repair.
CONCLUSIONS: SS laparoscopic herniorrhaphy appears as safe and effective as the traditional 3-port system with comparable outcomes andmcomplications. Success rate was greater than 95% in both groups.


Back to 2017 Program