Modified single-port vs two-port laparoscopic herniorrhaphy for children with concealed deferent duct: a retrospective study from a single institution.

PURPOSE: Single-port laparoscopic herniorrhaphy is widely employed for indirect inguinal hernia repair in children. However, few surgeons utilize the single-port technique to repair such hernias with concealed deferent ducts. The aim of this study was to assess the application of the modified single-port laparoscopic technique (MSPT) in cases with concealed deferent ducts and to compare the results to those obtained with the two-port technique (TPT).

METHODS: Between January 2006 and January 2012, all consecutive cases were retrospectively studied. The inclusion criteria were as follows: (1) age no more than 3 years; and (2) a concealed deferent duct identified by laparoscopy. Two-hundred and three children were treated using TPT from January 2006 to December 2008. One-hundred and ninety-three children were treated using MSPT from January 2009 to January 2012. The clinical variables and surgical outcomes were compared between the two groups.

RESULTS: The differences in operation duration, vessel injury, conversion, postoperative hydrocele occurrence and umbilical hernia were not significant between the two groups. Ipsilateral groin swelling was more common in the MSPT group. No wound infection, recurrence, metachronous hernia or testicular atrophy occurred in either group.

CONCLUSIONS: Despite the high incidence of ipsilateral groin swelling, MSPT is a feasible alternative to TPT in children with indirect inguinal hernias with multiple peritoneal folds. Furthermore, we have developed a new method to explore the contralateral groin using a single-port technique.