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RESULTS OF THE USE OF VARIOUS METHODS OF ENDOSCOPIC INGUINAL HERNIORRHAPHY IN CHILDREN


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Abstract

Introduction. Endoscopic inguinal herniorrhaphy in children has become widespread, but there are no comparative results of using various technologies for its implementation. Material and methods. The results of 1136 laparoscopic herniorrhaphies in children for inguinal hernia throughout the period from 2006 to 2016 were analyzed. The first group (GL1) comprised 812 patients who underwent laparoscopic suturing of an inguinal hernia with intracorporeal purse-string suture. The second group (GL2) included 324 children, who were treated with the subcutaneous endoscopically assisted ligation (SEAL) technology - single-ported transcutaneous herniorrhaphy with laparoscopic assistance. Children were operated most often at the age from 1 year to 7 years. The average age of patients in the first group amounts of 4.6 years, in the second group - 4.5 years. All herniorrhaphies were performed standardly, with the use of the same instrumentation. Results. There were revealed such advantages of the use of the SEAL method as the time of training of beginning surgeons to the technique of endoherniorrhaphy is shorter by 2.5 times at the preclinical stage of training, at the stage of assisting and bringing the independent technique of its implementation to perfection; the duration of the operation is shorter due to the exclusion of the time for the introduction of the second/third port and the imposition of an intracorporeal node that presents the greatest difficulty for beginning surgeons; the number of intra- and early postoperative complications do not differ in both groups. The number of relapses is greater in GL2 children with large inguinal and scrotal hernias. The duration of hospitalization in groups did not differ. Conclusion. The use of SEAL technology is economically more profitable due to the relative simplicity of technique of herniorrhaphy and the minimal use of the number of endoscopic instruments. In large inguinal and scrotal hernias, it is more appropriate to use the traditional technique of imposing intracorporeal suture.


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