title: Laparoscopic inguinal preperitoneal injection--novel technique for inguinal hernia repair: preliminary results of experimental study.
abstract: BACKGROUND
  Inguinal hernia repair is the most common procedure in pediatric surgery. Suture techniques for laparoscopic inguinal hernia repair in children are easy to perform and popular with a low recurrence rate. The aim of this study was to evaluate the effect of laparoscopic preperitoneal injection of three-dimensional gel on closing of the inguinal hernia sac (IHS) in laboratory animals.
  
  
  METHODS
  With the animals under general anesthesia, we performed peritoneoscopy in 12 male Chinchilla rabbits weighing 1200-1400 g. The endoscope was introduced into the abdominal cavity, and bilateral deep inguinal rings were identified. A Tuohy needle with the injectable polymeric bulking agent DAM+™ (three-dimensional polyacrylamide gel with silver ions [Argiform(®) from Bioform(®)]) was introduced preperitoneally. The implant was then injected across the entire orifice of the deep inguinal rings and draped over the cord structures. After completion of bilateral repairs, the rabbits were extubated and observed in the animal laboratory. Then the second laparoscopy was performed 6 months later, and the deep inguinal rings were inspected.
  
  
  RESULTS
  The postoperative course was uneventful in all the animals. At the second laparoscopy no reopening of the entire orifice of the deep inguinal rings was noted. Accurate placement of the polymeric agent and adequate coverage of the vas deferens were accomplished in all the animals.
  
  
  CONCLUSIONS
  This study demonstrates that the biopolymeric implant gives good postoperative results and a stable trend of closing the IHS in long-term follow-up. In conclusion, we hope that injectable polymeric bulking agents can be used for treatment of inguinal hernias of pediatric patients after additional animal and human research.
authors.affiliation: Department of Neonatal Surgery, Municipal Pediatric Hospital, Irkutsk, Russia. yuriherz@hotmail.com
authors.forename: Yury
authors.initials: Y
authors.lastname: Kozlov
authors.forename: Vladimir
authors.initials: V
authors.lastname: Novogilov
authors.forename: Andrey
authors.initials: A
authors.lastname: Rasputin
authors.forename: Alexey
authors.initials: A
authors.lastname: Podkamenev
authors.forename: Pavel
authors.initials: P
authors.lastname: Krasnov
authors.forename: Irina
authors.initials: I
authors.lastname: Weber
authors.forename: Alexey
authors.initials: A
authors.lastname: Solovjev
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage; D000818:Animals; D002682:Chinchilla; D004195:Disease Models, Animal; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods*; D007267:Injections; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019736:Prostheses and Implants; D012834:Silver / Q000008:administration & dosage; D018030:Silver Compounds / Q000008:administration & dosage; D000099166:Polyacrylamides
chemical_list: D000180:Acrylic Resins; D012834:Silver; D018030:Silver Compounds; D000099166:Polyacrylamides; C016680:polyacrylamide gels