BOB Ped Surg 2023 - Tran Ngoc Son, WOFAPs - Presentation

Dear colleagues, ladies and gentlemen, thank Wolffs and Stayoran MD for giving me the opportunity to present our work Laparoscopic percutaneous closure operated prostheses vaginalis without hydrosectomy for childhood primary hydrocele. The traditional hydrocele repair is open repair with an incision, high ligating other PPV and hydrosectomy, which can be total or a partial of an aspiration. Laparoscopic surgery, or LS is increasingly used in the treatment of peddiatric inguinal hernia, but not yet popular in the treatment of hydrocele. The aim of this study is to evaluate the feasibility and effectiveness of single incision laparoscopic experitoneal closure or SIPC, a PPV without hydrosectomy in primary hydrocele in children. We perform a prospective study on all children with primary hydrocin treated at our center for a 5 year period with inclusion and exclusion criteria as shown. For a simple procedure, two graphs were placed at the same 10 single umbilical incision. Under the laparoscopic vision and with the assistance of the grasper, PPV was closed extraperinally at the internal inguinal ring with a 20 suture using a percutaneous needle with a white lasso. No hydrosectomy or penetration or hydrocy was performed. The hydrocce fluid was pushed back to the peritoneal cavity via internal ring before the closure of PPV by external manual pressing, and with this step was uncessful. The foot was evacuated by a pocotaous needle puncture. 553 patients were enrolled in this study with a median age of 34 months ranged 2 years to 14 years. Isil lateral patent PPV was found in one of the patients, and in nearly 30% there was no obvious communication between the hydrocene with the peritoneal cavity. The median operative time was 70 minutes, and the median post-operative stay was 1 day. There were no major complications, and at a follow-up of 41 months, the recurrence rate was 0.36%. The prosperity cosmesis was excellent. Some meta-analysis showed that laparoscopic surgery has the advantages of less trauma, reduced prosperity pain, faster recovery, improved cosmesis, and fewer complications than conventional open surgery with the advantages of ability for exploration of the contralateral and internal inguinal ring. We know that simple puncture and fluid aspiration alone is ineffective in the management of hydrocele. The principle of laparoscopic management of periodic hydroxy are in controversion, while some authors use the same principles as open surgery, closure of the PPV of the internal ring. And hydrosyectomy or wide fenestration of the cyst under order perform high PPP ligation without hydrosyectomy with wood prisms. In this study we performed syn for PPV with a hydrosectomy. We found that ipsilatum PPV, or open internal inguinal ring, was present in all cases. In nearly 30% of our patients, the hydrocine has no obvious connection with the peritoneal cavity. In these cases, we still negated the PPV and evacuated the fluid in the cyst with a percutaneous needle. No recurrence was recorded. We suggest that in such cases there is a still discrete one-way passage of the pertinent fluid towards the scrotum, but not the opposite. The fluid in the primary hydrocele. Is actually the retinal fluid, not fluid produced by the hydrocyst itself, so there is no need of hydrocyectomy. You can see in this slide that laparoscopic management of pediatric hydrocy with a hydrosectomy had comparable outcomes in terms of recurrence compared to other reports with hydrosectomy. In conclusions, ipsilateum PPV was presented in all cases with primary hydrocy in our series. Our technique of syn of PPV without hydrosectomy is feasible, safe, with excellent prosperative cosmesis in the management of primary hydrocce in general. Thank you for your attention.