title: Feasibility of Single-Incision Laparoscopic Percutaneous Extraperitoneal Closure for Inguinal Hernia by Inexperienced Pediatric Surgeons: Single-Incision Versus Multi-Incision Randomized Trial for 2 Years.
abstract: OBJECTIVE
  This study evaluated the stability and risk of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) for pediatric inguinal hernia performed by inexperienced pediatric surgeons versus conventional LPEC procedure.
  
  
  METHODS
  Between 2011 and 2012, a randomized prospective study was performed comparing SILPEC (n = 37, 16 uni- and 21 bilateral patent processus vaginalis [PPV]) to LPEC (n = 72, 39 uni- and 33 bilateral PPV). The procedures were performed in girls with inguinal hernia by inexperienced pediatric surgeons with the assistance of an expert pediatric surgeon. In SILPEC, a laparoscope was placed through a transumbilical incision. A 2-mm trocar for the grasper was inserted through the same incision and introduced into the extraperitoneal cavity. The tip of the trocar was inserted in the abdominal cavity distant from the umbilical incision by the expert surgeon to avoid any complications caused by the in-line view. Using a special needle, the hernial sac was closed extraperitoneally by the inexperienced surgeon. A statistical survey of the mean age at operation, mean operative time, intra- and postoperative complications, and recurrence in the SILPEC and LPEC groups was performed.
  
  
  RESULTS
  There were no significant differences in the mean age or operative time. There were fewer total number of postoperative complications in the SILPEC group compared with the LPEC group (P = .0707). No intraoperative complications or recurrence occurred.
  
  
  CONCLUSIONS
  Considering the risks and need to improve endoscopic surgical skills with useful instruments specialized for SILPEC, inexperienced surgeons can successfully perform SILPEC safely under expert pediatric surgeons.
authors.affiliation: 1 Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University , Fukuoka, Japan .
authors.forename: Satoshi
authors.initials: S
authors.lastname: Obata
authors.affiliation: 1 Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University , Fukuoka, Japan .|2 Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital , Fukuoka, Japan .
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ieiri
authors.affiliation: 1 Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University , Fukuoka, Japan .
authors.forename: Takahiro
authors.initials: T
authors.lastname: Jimbo
authors.affiliation: 1 Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University , Fukuoka, Japan .|2 Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital , Fukuoka, Japan .
authors.forename: Ryota
authors.initials: R
authors.lastname: Souzaki
authors.affiliation: 2 Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital , Fukuoka, Japan .
authors.forename: Makoto
authors.initials: M
authors.lastname: Hashizume
authors.affiliation: 1 Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University , Fukuoka, Japan .
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Taguchi
mesh_terms: D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D061646:Operative Time; D010537:Peritoneum / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D058106:Wound Closure Techniques