Abstract
Purpose: The aim of this study was to evaluate the technical feasibility and efficacy of a sutureless laparoscopic hernia repair in a small animal model. The objective was to occlude the processus vaginalis with biocompatible fleece and/or fibrin glue as an alternative to suturing.
Methods: Sixty-three male CD rats were randomly assigned to one of three groups. In group A (n=21), the internal inguinal ring was filled with 0.5 ml fibrin glue. The second group (B, n=21) also received fibrin glue, and a biocompatible fleece was placed on top. The third group consisted of control animals (C, n=21). Eleven rats in each group underwent laparoscopic surgery. The remaining rats were operated using an open technique, and the paraductal lipomas were resected in addition to inguinal ring closure.
Results: Complete closure of the internal hernia ring was not achieved in any of the rats, neither in the laparoscopic group nor in the open group or the control group. The paraductal lipoma grew back to its normal size, although resection of the lipoma was performed during the first procedure.
Conclusion: The physiology of paraductal lipomas in this animal appears to make it an inadequate model for the study of laparoscopic inguinal hernia repair.
Key words
animal investigation - child - hernia repair - laparoscopy - minimally invasive
References
-
1
Esposito C, Montinaro L, Alicchio F. et al .
Technical standardization of laparoscopic herniorraphy in pediatric patients.
World J Surg.
2009;
33
(9)
1846-1850
-
2
Treef W, Schier F.
Characteristics of laparoscopic inguinal hernia recurrences.
Pediatr Surg Int.
2009;
25
(2)
149-152
-
3
Saranga Bharathi R, Arora M, Baskaran V.
Minimal access surgery of pediatric inguinal hernias: a review.
Surg Endosc.
2008;
22
(8)
1751-1762
-
4
Schier F, Turial S, Hückstädt T. et al .
Laparoscopic inguinal hernia repair does not impair testicular perfusion.
J Pediatr Surg.
2008;
43
(1)
131-135
discussion 135
-
5
Ozgediz D, Roayaie K, Lee H. et al .
Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: report of a new technique and early results.
Surg Endosc.
2007;
21
(8)
1327-1331
-
6
Hassan ME, Mustafawi AR.
Laparoscopic flip-flap technique versus conventional inguinal hernia repair in children.
JSLS.
2007;
11
(1)
90-93
-
7
Miyano G, Yamataka A, Kato Y. et al .
Laparoscopic injection of dermabond tissue adhesive for the repair of inguinal hernia: short- and long-term follow-up.
J Pediatr Surg.
2004;
39
(12)
1867-1870
-
8
Kato Y, Yamataka A, Miyano G. et al .
Tissue adhesives for repairing inguinal hernia: a preliminary study.
J Laparoendosc Adv Surg Tech A.
2005;
15
(4)
424-428
-
9
Avital S, Itah R, Szomstein S. et al .
Correlation of CO2 pneumoperitoneal pressures between rodents and humans.
Surg Endosc.
2009;
23
(1)
50-54
-
10
Avital S, Inbar R, Ben-Abraham R. et al .
Effect of small bowel perforation during laparoscopy on end-tidal carbon dioxide: observation in a small animal model.
J Surg Res.
2007;
143
(2)
368-371
-
11
Gougoudi E, Pikoulis E, Karavokyros I. et al .
Outcome of Fowler-Stephens operation for undescended testes: an experimental study.
J Androl.
2007;
28
(6)
813-820
-
12
Papparella A, Noviello C, Romano M. et al .
Local and systemic impact of pneumoperitoneum on prepuberal rats.
Pediatr Surg Int.
2007;
23
(5)
453-457
-
13
Bishara B, Karram T, Khatib S. et al .
Impact of pneumoperitoneum on renal perfusion and excretory function: beneficial effects of nitroglycerine.
Surg Endosc.
2009;
23
(3)
568-576
-
14
Lau H, Loong F, Yuen WK. et al .
Management of herniated retroperitoneal adipose tissue during endoscopic extraperitoneal inguinal hernioplasty.
Surg Endosc.
2007;
21
(9)
1612-1616
-
15
Carilli S, Alper A, Emre A.
Inguinal cord lipomas.
Hernia.
2004;
8
(3)
252-254
-
16
Laje P, Peranteau WH, Flake AW.
Repair of indirect inguinal hernias by “laparoscopic joining of the edges”.
Surg Laparosc Endosc Percutan Tech.
2008;
18
(3)
280-282
Correspondence
Dr. Salmai Turial
University Medical Center
Department of Pediatric
Surgery
Langenbeckstraße 1
55101 Mainz
Germany
Phone: +49 6131 17 7107
Fax: +49 6131 17 6523
Email: salmai.turial@unimedizin-Mainz.de
