title: Laparoscopic extraperitoneal repair of symptomatic hydrocele in children: a single-center experience with 73 surgeries.
abstract: OBJECTIVE
  To introduce a novel, two-port laparoscopic technique for treatment of hydrocele in children, which allows completely extraperitoneal closure of the patent processus vaginalis (PPV) and does not necessitate laparoscopic suturing skills.
  
  
  METHODS
  We describe a consecutive series of 56 boys with a median age of 36 months (range 12-144 mos) who presented with a presumably communicating hydrocele. Laparoscopic repair of these hydroceles was performed between July 2009 and June 2010. During surgery, a 5-mm laparoscope and a 3-mm grasping forceps were inserted through an identical umbilical incision (10 mm). The hydrocele sac orifice was closed extraperitoneally by circuit suturing around the internal inguinal ring.
  
  
  RESULTS
  All cases were preoperatively diagnosed to be unilaterally based on physical examination and ultrasonography. During surgery, 17 of the 56 (30%) patients presented a contralateral PPV. A total of 73 laparoscopic procedures were achieved, with a success rate of 100%. The mean operative time was 25±6 and 36±5 minutes for unilateral and bilateral operations, respectively. During a median follow-up period of 6 months (range 1-12 mos), neither recurrence nor other postoperative complication was encountered.
  
  
  CONCLUSIONS
  Our limited experiences suggest that the two-port, totally extraperitoneal laparoscopic technique could be a safe, effective, and reliable alternative for management of pediatric hydrocele.
authors.affiliation: Department of Urology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: De-juan
authors.initials: DJ
authors.lastname: Wang
authors.forename: Jian-guang
authors.initials: JG
authors.lastname: Qiu
authors.forename: You-qiang
authors.initials: YQ
authors.lastname: Fang
authors.forename: Tu-jie
authors.initials: TJ
authors.lastname: Si
authors.forename: Jian-bin
authors.initials: JB
authors.lastname: Luo
authors.forename: Xin
authors.initials: X
authors.lastname: Gao
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D010537:Peritoneum / Q000601:surgery*; D013537:Sutures; D006848:Testicular Hydrocele / Q000473:pathology* / Q000601:surgery*; D014945:Wound Healing