Fayaz-ur Rahman.
Comparison of single port and three port laparoscopic technique of inguinal hernia repair in children.
Pak J Med Res Jan ;57(4):181-5.

Background: Laparoscopic repair of inguinal hernia has been commonly practiced nowadays, however an extensive debate exist regarding the different techniques and the numbers of port used for its repair. Objective: To share our institutional experience and to compare the outcome of two different laparoscopic techniques of inguinal hernia repair in children. Study design, settings and duration: A prospective randomized controlled trial was conducted at pediatric surgery unit, Khyber Teaching Hospital, Peshawar from July 2015 to January 2017. Subjects and Methods: The children aged below 16 years with a diagnosis of reducible inguinal hernia (IH) were randomly assigned into 2 groups of repair of inguinal hernia, single port laparoscopic needle assisted repair (LNAR) and three port technique of purse string around deep inguinal ring (PSDIR). Demographic and clinical data was collected and analyzed using SPSS 20. Results: A total of 205 laparoscopic repair of inguinal hernia done on 153 patients by the same group of surgeon in same unit. 83 patients underwent single port LNAR with 5 patients having bilateral inguinal hernia and 22 contralateral patent processus vaginalis (CPPV). Seventy patients underwent three port technique of PSDIR having 7 cases with bilateral IH and 18 CPPV. Age ranges from 0 to 16 years with a mean age for single port LNAR 3.6±3.21 years and three ports PSDIR 4.69±3.08 years. Mean weight for single port LNAR 10.5±5.24 kg and PSDIR 12.33±7.47 kg. Mean operating time for unilateral LNAR 10±2.91 min and PSDIR 25.68±3.55 min while bilateral LNAR 16±3.88 min and PSDIR 40±5.59 min. Length of hospital stay (LOHS) for LNAR 30±4.50 hours and PSDIR 38.57±6.15 hours. Analgesia doses for Unilateral LNAR 4.56±1.15 and PSDIR 7.51±1.57 while analgesia for Bilateral LNAR 7.0±1.26 and PSDIR 10.6±1.84. PSDIR has high postoperative complications of recurrence, hydrocele and poor parents satisfaction score. Conclusion: Our results support single port LNAR of inguinal hernia using spinal needle as safe, reliable and effective technique with a high parents satisfaction as compared to three port technique.

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