Application of a Laparoscopic, Single-port, Double-needle Technique for Pediatric Hydroceles With Multiple Peritoneal Folds: A Trial From a Single-center 5-Year Experience.

OBJECTIVE: To report our 5-year experience with a modified single-port, double-needle, minilaparoscopic technique for patent processus vaginalis with multiple peritoneal folds in the hydrocele sac orifice.

METHODS: A total of 125 consecutive cases of boys with unilateral pediatric hydrocele underwent minilaparoscopic repair between June 2008 and June 2013. The patients were divided into 2 groups. Group 1 consisted of 65 patients who underwent a 2-port laparoscopic procedure, during which a 3-mm grasping forceps was used to grasp the folds around the internal inguinal ring. Group 2 included 60 patients who received a modified single-port, double-needle, minilaparoscopic surgery. An Endo Close needle was used to spread the peritoneal folds and facilitate circular extraperitoneal suturing in group 2. The principal outcome factors were assessed between the groups.

RESULTS: A total of 151 minilaparoscopic procedures were performed in 125 patients (age range, 12-68 months; median, 21.5 months). In total, 26 extra procedures were performed for simultaneous repair of a potential contralateral patent processus vaginalis. No significant difference in operation time was noted between group 1 and group 2 (25.9 ± 6.4 vs 27.1 ± 5.5 minutes). The procedures were performed successfully without serious preoperative complications. During a median follow-up period of 18 months (range, 6-36 months), no postoperative hydrocele recurrence was encountered.

CONCLUSION: Our limited experience suggests that the modified single-port, double-needle, minilaparoscopic technique could be safe, effective, and more cosmetically appealing for the management of complicated pediatric hydroceles.