LAPAROSCOPIC NEEDLE ASSISTED REPAIR OF INGUINAL HERNIA USING SPINAL NEEDLE

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Inayat Ur Rehman
Fayaz` ur Rahman
Mohammad Imran
Zia Ur Rehman
Hazrat Amin
Waheed Akhtar
Ridhwan Ur Wahab

Abstract

Objectives: To know the outcome of Laparoscopic Needle assisted repair of inguinal hernia using spinal needle.
Material and Methods: Retrospective chart review was carried out in pediatric surgery unit of the Khyber Teaching
Hospital, Peshawar-Pakistan from may 2015 to july 2017. One hundred and forty four single incision laparoscopic needle
assisted repair (LNAR) performed on 105 patients. 30 degree telescope of 3mm was used through a supraumbilical
port to complete hernia repair and to examine contralateral, deep inguinal ring (DIR) as well. Using non absorbable
suture in spinal needle of 22G DIR was encircled extraperitoneally and extracorporeal knot was taken in subcutaneous
plan to close the ring.
Results: One Hundred and forty four single ports LNAR performed on 105 patients. 9 patients had bilateral inguinal
hernia and 30 patients had contralateral patent processus vaginalis (CPPV). Age ranges from one month to 16 years
with a mean age of 3.7±2.7years. Gender distribution shows, male 79% (83 out of 105) and female 21% (22 out of 105).
Mean weight of patient’s 10.2±5 kg. Preoperative Laterality, unilateral IH was in 91.2% and bilateral IH 8.8%. CPPV was
detected in 28% (30 out of 105). Operative time for unilateral hernia repair 10.18±2.73 min and bilateral hernia repair
16.38±3.28 min. Mean length of hospital stay (LOHS) was 31.79±6.08 hours. Analgesia doses required in unilateral
cases were 5±1 doses while in bilateral 7.17±1 doses. The hernia recurrence and hydrocele was recorded in 2.8%
and 0.95% cases respectively. Wound infection and testicular atrophy rate is 0% in this short series.
Conclusion: Single port laparoscopic repair of inguinal hernia using a spinal needle with non-absorbable suture is a
safe and effective method having a comparable postoperative complication rate.

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