Abstract
The presence of excessive folds or scar tissue in the inguinal region significantly complicates the intraperitoneal suturing of the internal ring when employing a laparoscopic transumbilical approach for repairing inguinal hernias in male pediatric patients. From January 2020 to March 2024, we utilized three distinct surgical techniques-needle-to-needle suturing, auxiliary suture-assisted suturing, and additional port-assisted suturing-to address the internal ring with excessive folds or scar tissue in 112 male pediatric patients who underwent laparoscopic transumbilical intraperitoneal repair for inguinal hernias at our hospital. For each technique, we recorded the duration of unilateral internal ring suturing as well as instances of bleeding, surgical complications, length of hospital stay, and recurrence rate. All procedures were successfully completed without conversion to open surgery. There was one instance of bleeding associated with the needle-to-needle technique used for internal ring suturing; however, no other complications were observed. The duration of unilateral internal ring suturing varied as follows: 3.1 ± 0.3 min for the needle-to-needle technique (47 cases), 2.8 ± 0.2 min for the auxiliary suture-assisted technique (49 cases), and 2.2 ± 0.3 min for the additional port-assisted technique (29 cases). All patients underwent day surgery, and there was a 0% recurrence rate at six months post-operation. Distinct surgical techniques-needle-to-needle suturing, auxiliary suture-assisted suturing, and additional port-assisted suturing-hold significant clinical value for laparoscopic transumbilical intraperitoneal suturing of the internal ring in male pediatric patients. The optimal surgical approach should be customized based on the patient's anatomy and the surgeon's expertise.