title: A Modified Approach for Inguinal Hernias in Children: Hybrid Single-Incision Laparoscopic Intraperitoneal Ligation.
abstract: OBJECTIVE
  To report a laparoscopic approach for pediatric inguinal hernia repair using a hybrid single-incision laparoscopic (H-SIL) technique and its clinical outcomes.
  
  
  METHODS
  A retrospective study was carried out in inguinal hernia cases treated with the new H-SIL approach using intracorporeal jumping purse-string sutures. The operative time, length of postoperative hospital stay, efficiency of the operation, and complications were analyzed.
  
  
  RESULTS
  In total, 157 inguinal high ligations were performed in 106 children (89 boys, 17 girls). The median age was 1.5 years (range, 25 days-11.6 years). The mean operative time was 15.8±3.4 minutes for the single-side procedure and 20.3±2.5 minutes for bilateral procedures. The mean postoperative hospital stay was 0.99±0.52 (range, 0.25-3 days). No postoperative bleeding, abdominal wall emphysema, abdominal viscera injury, or scrotal edema was found, and there were no known cases of postoperative testicular atrophy or hypotrophy. Ninety-three percent of the patients became fully mobile on the first postsurgical day. The median follow-up period was 17 months (range, 9-21 months), with no recurrence, no visible scars on the abdominal wall, and no foreign body felt in the inguinal region.
  
  
  CONCLUSIONS
  This H-SIL approach is a safe and efficient method for pediatric inguinal hernia repair. The maneuverability is the same as that in the triport laparoscopic technique, and the cosmetic results are similar to those of single-port laparoscopic surgery.
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Shuai
authors.initials: S
authors.lastname: Li
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Shao-tao
authors.initials: ST
authors.lastname: Tang
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Tajammool Hussein
authors.initials: TH
authors.lastname: Aubdoollah
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Shiwang
authors.initials: S
authors.lastname: Li
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Kang
authors.initials: K
authors.lastname: Li
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Qiang-song
authors.initials: QS
authors.lastname: Tong
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Yong-zhong
authors.initials: YZ
authors.lastname: Mao
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Guoqing
authors.initials: G
authors.lastname: Cao
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Jiarui
authors.initials: J
authors.lastname: Pu
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Hong
authors.initials: H
authors.lastname: Mei
authors.affiliation: 1 Department of Pediatric Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .
authors.forename: Xinxing
authors.initials: X
authors.lastname: Wang
authors.affiliation: 2 Department of General Surgery, Wu Han Children's Hospital , Wuhan, China .
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008026:Ligation / Q000009:adverse effects / Q000379:methods; D008297:Male; D061646:Operative Time; D012008:Recurrence; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome