title: A new modification of laparoscopic percutaneous extraperitoneal closure procedure for repairing pediatric femoral hernias involving a special needle and a wire loop.
abstract: Femoral hernias are relatively rare in children, and more than half of pediatric femoral hernias are misdiagnosed. A 3-year-old boy was treated for an indirect inguinal hernia at the age of 2, but he exhibited an inguinal bulge one month after the operation. He underwent laparoscopy, and a right femoral hernia was detected. The femoral hernia was laparoscopically repaired via two small incisions: a 1.0-cm umbilical incision for a 3-mm 30° laparoscope and 3-mm grasping forceps and a 5-mm right lateral incision for 3-mm grasping forceps. After the hernia sac had been reflected into the abdominal cavity and resected, the iliopubic tract was sutured to Cooper's ligament using a laparoscopic percutaneous extracorporeal closure (LPEC) needle and 2-0 non-absorbable sutures. Laparoscopy enables the accurate diagnosis of rare and often missed pediatric femoral hernias. Our laparoscopic technique for treating femoral hernias is easy and effective. Although these early results are encouraging, more cases involving longer follow-up periods should be accumulated to confirm the efficacy of our technique.
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Tainaka
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Uchida
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Akihide
authors.initials: A
authors.lastname: Tanano
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Chiyoe
authors.initials: C
authors.lastname: Shirota
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yokota
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Murase
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Makita
authors.affiliation: Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Shirotsuki
keywords: LPEC needle; femoral hernia; laparoscopic repair