ObjectiveTo compare the effects of medical glue and stapling in the prevention of postoperative seroma for patients undergoing laparoscopic direct hernia repair.
MethodsNinty-four patients were randomly by computer generated randomization number divided into two groups: medical glue group (medical glue was used to fix pseudo-direct hernia sac) and stapling group (staple was used to fix pseudo-direct hernia sac).The time of follow-up was two years.The operative time, length of hospital stay, the pain level on first day and 7th day after operation, postoperative complications (seroma, wound infection, wound bleeding), hospital costs, and hernia recurrence rate within 2 years were observed.
ResultsThe medical glue group compared with the stapling group, the operative time was shorter〔(35±5.1) min vs.(41±7.5) min〕, hospitalization time was shorter〔(4±0.51) d vs.(5±0.83) d〕, lower postoperative pain score〔the first day: (5±0.52) scores vs.(6±0.33)scores; the 7th day: (3±0.67) scores vs.(4±0.53) scores〕, and lower cost in hospital〔(5 731±560.50) yuan vs.(8 715±534.33) yuan〕, there were significant difference (P < 0.05).The incidence of seroma and other complications after operation and postoperative 1-year and 2-year hernia recurrence rate showed no significant differences (P > 0.05).
ConclusionsThe medical glue has good prevention effects on postoperative seroma for patients undergoing laparoscopic direct hernia surgery, with shorter operative time and lower cost.This method is suitable for all levels of hospitals
Objective
To investigate the clinical value of laparoscopic high ligation of hernia sac with constructed veress needle in the treatment of indirect inguinal hernia in children.
Methods
Ninety-one cases of pediatric indirect inguinal hernia who received treatment in Suqian People’s Hospital of Nanjing Drum-Tower Hospital Group from October 2014 to December 2015 were selected and randomly divided into two groups, cases of laparoscopy group (n=41) were treated by laparoscopic high ligation of hernia sac with constructed veress needle, and cases of tradition group (n=50) were treated with traditional open high ligation of hernia sac. Comparison of clinical effect between the 2 groups was performed.
Results
All the operations were successfully carried out, and there was no conversion to open surgery in laparoscopy group. Three cases were diagnosed as two-side inguinal hernia in laparoscopy group, who were diagnosed as one-side inguinal hernia before operation. The operation time, length of surgical incision, blood loss, and hospital stay of the laparoscopy group were all significantly less than those of the tradition group (P<0.05). The incidence of postoperative complications such as scrotal edema and scrotal hydrocele, incidence of testicular dysplasia, and the recurrence rate in the laparoscopy group were all significantly lower than those of the tradition group (P<0.05).
Conclusions
Laparoscopic high ligation of hernia sac with constructed veress needle in the treatment of indirect inguinal hernia in children has good application value, which has advantages of small surgical trauma, shorter hospital stay, faster recovery, and less postope-rative complications, and we can find out contralateral recessive hernia during operation and avoid the second surgery.
ObjectiveTo survey the feasibility of laparoscopic high ligation for pediatric inguinal hernias by performing the surgery on rabbit models.
MethodsLaparoscopic high ligation was operated on 32 healthy New-Zealand male rabbits. Eight random rabbits were observed under laparoscope on the 7th, 15th, 30th, and 60th days after operation, and the anti-tension strength at the instant when hernial inner ring cracked was measured. Repair regions were resected. After HE-staining, the syzygial status of the repair regions were checked.
ResultsNone of the rabbits died during the research with no such complications as ankylenteron intestinal obstruction or hernia relapses after surgery. The anti-tension strength by the inguinal regions of the experimental rabbits after surgery on the 7th, 15th, 30th, and 60th days was respectively (42.69±6.98), (69.31±6.52), (102.64±7.91), and (106.53±7.54) mm Hg (1 mm Hg=0.133 kPa). As for the pathological section observation, the agglutination of the repair region was consistent with reparative process of chronic nonbacterial inflammation.
ConclusionThe operation of laparoscopic high ligation for repairing inguinal hernia on rabbits is safe and reliable.
