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VR-21
(VS)
LAPAROSCOPIC TRANSCUTANEOUS EXTRAPERITONEAL REPAIR OF HYDROCELE
IN CHILDREN BY USING J SHAPED BENDED SPINAL NEEDLE
Ji Yong HA and Wonho JUNG
School of medicine, Keimyung university, Urology, Daegu, KOREA (REPUBLIC OF)
PURPOSE
To introduce a unique technique, single port laparoscopic assisted extraperitoneal closure of patent processus vaginalis
using J shaped bended spinal needle.
MATERIAL AND METHODS
Sixteen children underwent Laparoscopic Transcutaneous Extraperitoneal (LTE) repair of hydrocele by using J shaped
bended spinal needle.
A 2.7-mm 30-degree laparoscope was inserted through an umbilical incision. The scope could view both inguinal ring. J
shaped bended 18G spinal needle was inserted just 5mm lateral to the internal inguinal ring. The needle was introduced
to the extraperitoneal space over the vas deferens and spermatic vessels, injecting of saline for the preperitoneal
hydrodilation. A 3-0 polyester suture was threaded through an 18G spinal needle. Same 3-0 polyester suture was
threaded through an 20G spinal needle from the tip. Along the guidace of the suture and 18G needle, J shaped bended
20G spinal needle was reintroduced to extraperitoneal space. 20G spinal needle traveled through the upper margin of
internal ring, 20G needle tip was pulled out of the initial 18G needle puncturd opening. 3-0 polyester suture was pulled
outside from the 20G needle tip and then 20G needle is also withdrawn. After all these procedure, internal inguinal ring
was completely encircled and tied extracorporeally. The knot was buried in the subcutaneous area within the punctured
needle hole.
RESULTS
All patients were discharged on the same day after surgery without any complication. During a mean follow-up period
of 8 months (range 1-12mo), no recurrence has been observed except first 2 cases.
CONCLUSIONS
This LTE technique is simple, fast, safe and cosmetic procedure for pediatric hydrocele.