Harmonic Scalpel Technique in Adolescent with Non communicating Hydrocele
Mark Zaontz, M.D.1, Christopher Long, M.D.1, Thomas Kolon, M.D.1, David Ben-Meir, M.D.2.
1Childrens Hospital of Philadelpha, Philadelphia, PA, USA, 2Schneider Children's Medical Center of Israel, Tel Aviv, Israel.
Repair of a non communicating hydrocele is generally corrected by using either a "bottle" or 'imbrication" technique. The video presented demonstrate a novel way to correct non communicating hydroceles using a harmonic scalpel technique. The harmonic scalpel has the advantages of completely sealing the encountered lymphatics and blood vessels encountered and allows for trimming the tunica vaginalis around the testis. In this way there is minimal bulk remaining and the procedure can be done safely and quickly. We have operated on 35 boys today with a mean age of 14.6 years. Follow-up mean was 13.7 months. There were 2 complications which included 2 wound site seromas thought to be secondary to analgesic infiltration of the scrotal incision. There were no recurrent hydroceles and minimal post op swelling. As an added benefit we noted that returning patients commented that there was minimal discomfort and very little if any need for narcotic use post op. We conclude that the harmonic scalpel hydrocele repair is a safe, effective and reproducible technique.
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