Two-Port Needle-Assisted Pediatric Laparoscopic Herniotomy Using Tuohy Needle: Clinical Experience and Outcomes
Background: Traditionally, inguinal hernia in the pediatric population is managed with open herniotomy; the procedure has evolved significantly with the advancement of minimally invasive laparoscopic techniques. Tuohy Needle-assisted Laparoscopic hernia repair has several advantages over the open r...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
ziauddin University
2025-07-01
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| Series: | Pakistan Journal of Medicine and Dentistry |
| Subjects: | |
| Online Access: | https://ojs.zu.edu.pk/pjmd/article/view/3756 |
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| Summary: | Background: Traditionally, inguinal hernia in the pediatric population is managed with open herniotomy; the procedure has evolved significantly with the advancement of minimally invasive laparoscopic techniques. Tuohy Needle-assisted Laparoscopic hernia repair has several advantages over the open repair technique, including shorter recovery times, the ability to evaluate and repair contralateral defects, reduced postoperative complications, and improved outcomes.
Methods: This descriptive case series study was conducted in the Department of General Surgery at Sharif Medical City Hospital, Lahore, over a period of six months. A total of 60 children aged between 2 and 12 years with a diagnosis of reducible inguinal hernia were enrolled utilizing non-probability consecutive sampling. Patients with bilateral or recurrent hernias were also included. After obtaining written informed consent, laparoscopic herniotomy was performed using a two-port technique with a 23-G Tuohy needle and 3/0 Prolene for extracorporeal closure. Total operative time was recorded from the initial port placement to skin closure. Analgesia requirements were also recorded as the number of doses given postoperatively, using a visual analogue scale. The Length of hospital stay was recorded in days from the day of admission until the patient’s discharge. Data were analyzed using SPSS version 23. Mean and standard deviation were calculated for quantitative variables like operative time, analgesia dose, and Length of Hospital stay LOHS, and stratification was done for age, weight, laterality (side of hernia), and recurrence.
Results: A total of 60 pediatric patients with an age range of 2 to 12 years and a mean age of 7.1 years were included, with a mean weight of 23.2 kg. It included 47 males (78.3%) and 13 females (21.7%). The majority of pediatric patients had left-sided hernia (58.3%), followed by right-sided (28.3%) and bilateral hernia (13.3%). Only one patient (1.7%) out of 60 presented with a recurrent inguinal hernia. The mean total operative time for laparoscopic needle-assisted herniotomy using the Tuohy needle was 15.8 minutes. The average postoperative analgesia requirement was 1.7 doses, and the mean length of hospital stay was one day. No major intraoperative complications were observed.
Conclusion: The two-port laparoscopic needle-assisted herniotomy using a Tuohy needle is a safe, highly effective, and minimally invasive laparoscopic technique for inguinal hernia repair in the pediatric population. It offers favorable operative duration, minimal analgesia dose needs, and shorter hospital stays, with excellent cosmetic outcomes and low recurrence rates.
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| ISSN: | 2313-7371 2308-2593 |