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Efficacy of a modified needle grasper for single-port laparoscopic hernia repair in children: a propensity score-matched analysis

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Abstract

Purpose

The advantage of using the single-port technique over the conventional two-port approach is uncertain. This study aimed to evaluate the outcomes of a single-port laparoscopic percutaneous extraperitoneal closure (SLPEC) using a modified needle grasper in children and compare the results to those of two-port laparoscopic percutaneous extraperitoneal closure (TLPEC).

Methods

A retrospective cohort analysis of SLPEC and TLPEC surgery from February 2016 to June 2021 was conducted at our institution. Pediatric patients underwent SLPEC using the modified needle grasper to complete the high ligation of the hernia sac, while operations in the conventional two-port group only used regular laparoscopic instruments. A 1:1 propensity score matching (PSM) analysis was used to reduce selection bias.

Results

Of 1320 patients, 1169 were included in the single-port/two-port crude evaluation, with 930 in the PSM cohort (465 patients/arm). Among 1:1 matched patients, the operation time for single-port patients vs. two-port patients were 11.28 ± 3.98 vs. 15.47 ± 4.54 min for unilateral repair and 16.86 ± 4.59 vs. 20.40 ± 4.29 min for bilateral repair (p < .05). Cosmetic results did not differ between the SLPEC and TLPEC groups (0% vs. 0.7%, p = 0.249). The recurrence rates were comparable between the two groups (0.6% vs. 1.1%, p = 0.725). Moreover, the differences in surgical site infection (SSI), testicular atrophy, open conversion and postoperative hydrocele occurrence were insignificant between the two groups.

Conclusions

In this cohort study, the modified needle grasper is a safe and feasible instrument for SLPEC, and SLPEC using the needle grasper has a shorter operation time than TLPEC.

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Data availability

The data are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Wenjun Wang to conduct the ultrasonic inspections and Carl Kenobi to improve the English writing.

Funding

This study was supported by the Natural Science Foundation of Zhejiang Province (Grant Number LGF20H030007).

Author information

Authors and Affiliations

  1. Department of General Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Qicen Liu

  2. Department of Hernia Surgery, Huangshan City People’s Hospital, Huangshan, China

    Tao Xu, Yi Huang, Xiaodong Wu, Yong Hu & Rui Zhang

  3. Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

    Bin Gao

  4. Department of Hernia and Abdominal Wall Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Fangjie Zhang

Authors
  1. Qicen Liu
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  2. Tao Xu
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  3. Yi Huang
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  4. Xiaodong Wu
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  5. Bin Gao
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  6. Yong Hu
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  7. Rui Zhang
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  8. Fangjie Zhang
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Contributions

Study conception and design: QL and FZ. Acquisition of data: TX, YH, RZ and YH. Analysis and interpretation of data: TX and XW. Drafting of manuscript: QL. Critical revision of manuscript: FZ, BG, YH and RZ.

Corresponding author

Correspondence to Fangjie Zhang.

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Conflict of interest

The authors have no conflicts of interest or financial ties to disclose.

Ethical approval

The Institutional Review Board of Huangshan City People’s Hospital reviewed and approved this study (2022-C-002).

Consent for publication

Informed consent was obtained from the legal guardians of all patients in this study.

Human and animal rights

This study only contains human participants and without animal involvement.

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Liu, Q., Xu, T., Huang, Y. et al. Efficacy of a modified needle grasper for single-port laparoscopic hernia repair in children: a propensity score-matched analysis. Pediatr Surg Int 39, 278 (2023). https://doi.org/10.1007/s00383-023-05560-5

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