Page 98 - Read Online

Helal Helal simplified technique

A B A B

Figure 2: (A and B) Both ends of the thread was picked out from
the epidural needle using a trans-umbilical laparoscopic needle
holder and pulled outside of the abdomen
A B

C D

Figure 3: (A and B) Complete extra-peritoneal purse string around
the internal inguinal ring
8. The end of the thread was picked out from the EN
using a trans-umbilical laparoscopic needle holder, Figure 4: (A and B) The end of the thread was pulled out through
and pulled outside of the abdomen [Figure 2A]. The the trans-umbilical incision; (C and D) the self sliding extacorporeal
clinch knot was tied
thread was held outside of the abdomen and the
needle holder was reintroduced. A B

9. The EN was withdrawn backwards to the starting
point at 3 o’clock meridian, and then advanced along
the upper margin of the IIR beneath the peritoneum to
come out from the same peritoneal puncture at 9 o’clock
meridian, where the other end of the thread was picked
out of EN by the needle holder and also pulled outside
of the abdomen [Figures 2B and 3].

10. The suture was tied using a self-sliding Figure 5: (A) Complete closure of the internal inguinal ring with
intra-corporeal knotting; (B) finally the umbilicus was closed leaving
extracorporeal clinch knot, as described by Weston, [16] an almost invisible scar
and this was reinforced with single instrument
intracorporeal knot tying, as described by Ismail and underwent SILHR. Demographic, preoperative,
Shalaby [Figures 4 and 5A]. [13] intraoperative, and postoperative data were collected
and analyzed. The mean age was 2.0 ± 2.2 years
11. Finally, the umbilical incision was closed [Figure 5B]. (range 6 months to 7 years). The demographic data
of all patients are shown in Table 1. All cases were
RESULTS completed laparoscopically. The mean operative time
was 8.0 ± 2.3 min for unilateral cases and 16.0 ± 4.3 min
One hundred female children with 120 inguinal hernias for bilateral cases. All patients achieved full recovery

Table 1: Patient demographic data
Age Clinical presentation Operative presentation Complications
No. of
patients Gender Mean Range Left inguinal Right inguinal Bilateral inguinal Intraoperative Postoperative
hernia
hernia
hernia
2 ± 2.2 6 months
100 (100%) Female 46 (46%) 34 (34%) 20 (of clinically left) Nil Nil
years -7 years
Mini-invasive Surgery ¦ Volume 1 ¦ June 30, 2017 91