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Helal. Mini-invasive Surg 2017;1:89-94 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2016.10
www.misjournal.net
Short Communication Open Access

Single-incision laparoscopic closure of

inguinal hernia in female children:

a simplified technique

Ahmed AbdElghaffar Helal
Department of Pediatric Surgery, Al-Azhar University, Cairo 11435, Egypt.

Correspondence to: Prof. Ahmed AbdElghaffar Helal, Department of Pediatric Surgery, Al-Houssain University, Darrasa, Cairo 11435, Egypt.
E-mail: helalhmada@yahoo.com

How to cite this article: Helal AA. Single incision laparoscopic closure of inguinal hernia in female children: a simplified technique. Mini-invasive Surg
2017;1:89-94.

Ahmed AbdElghaffar Helal, MBBCH, MSc, MD, is the Associate Professor of pediatric surgery within the Department of
Pediatric Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. Dr. Helal received his medical degree in the
University of Al-Azhar. He is one of the leading pediatric laparoscopic surgeon in Egypt. He published many papers in
various journals including Journal of Pediatric Surgery, Annals of Pediatric Surgery, and Journal of American Science.
He is a membership of the British Association of Pediatric Surgeons (BAPS), the Egyptian Pediatric Surgical Association
(EPSA), and the Egyption Society of Laparoscopic Surgery (ESLS). Dr. Helal obtained his postgraduate doctoral degree
(MD of Pediatric Surgery) on the research of the urological complication after pull through procedures for treatment of Hirschsprung’s
disease in children. He is the world leading experts in minimal invasive laparoscopic pediatric procedures. He performed the first noveal
laparoscopic repair of female inguinal hernia using single laparoscopic instrument in the world.

ABSTRACT
Article history: Aim: Single-incision laparoscopic hernia repair (SILHR) is a popular technique, especially
Received: 20-12-2016 in female children, as it reduces the number of incisions while achieving a better cosmetic
Accepted: 05-04-2017 outcome. However, intracorporeal suturing and knotting remains a major obstacle during
Published: 30-06-2017 SILHR and it requires a relatively long learning curve. Conversely, extracorporeal suturing and
knotting is straightforward, though it has several drawbacks. The purpose of this report is to
Key words: describe a simple technique for SILHR in female children. Methods: Between May 2014 and
Single incision, December 2016, 100 girls with 120 hernias of the Canal of Nuck (34 with right-side inguinal
intracorporeal knotting, hernia, 46 with left-side hernia, and 20 with bilateral hernia) underwent SILHR. The opened
laparoscopic hernia repair, internal inguinal ring was closed using a complete purse string suture fashioned by epidural
simplified technique, needle with intracorporeal knot tying. The main outcomes were feasibility, operative time,
female hernia complications and cosmetic outcome. Results: The mean age was 2.0 ± 2.2 years, and the mean
operative time was 8.0 ± 2.2 min for unilateral hernia repair and 16.0 ± 4.3 min for bilateral
cases. All cases were completed laparoscopically without intraoperative complications. During
follow-up, there were no recurrences and umbilical scars were almost invisible. Conclusion:
This simplified technique is feasible, quick, achieves better cosmetic results in female children,
and avoids the drawbacks of extracorporeal knotting.

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