Laparoscopic cauterization of hernia sac in girls; the Burnia technique

Abstract

INTRODUCTION: Inguinal hernia repair is one of the most common surgical procedures in pediatric surgery. In parallel with the advances in the field of medicine, various laparoscopic techniques have been developed in inguinal hernia repair. The Burnia technique is one of the latest published techniques and it is the cauterization of the inguinal hernia sac laparoscopically without using sutures in girls. The aim of this study is the investigation of the use of Burnia technique in clinical practice, and its postoperative outcomes. Any article concerning the use of this technique in Turkey has not been encountered. METHODS: The demographic features of patients, preoperative, peroperative, postoperative and follow-up results of 41 patients who had been operated with Burnia technique by a single surgeon within 2 years were reviewed retrospectively. Laparoscopically, the camera was first placed at an inclination of 30 degrees to the umbilical region using Hasson technique, and then, a single port was used for cauterization of the hernia sac. The Hernia sac was pulled into the abdominal cavity and cauterized. RESULTS: Burnia technique was applied to 62 inguinal hernia sacs in 41 girls. Their ages ranged from 1.5 to 16 years (median 36 months) with body weights ranging between 3.5 kg-40 kg (median 12 kg). Preoperatively 15 patients had right (37%), 19 patients left (46%), 7 patients bilateral inguinal hernias (17%). During surgery, 14 of the unilateral inguinal hernias were found to have a hernia sac on the contralateral side, and the rate of bilateral hernia increased to 51 percent. In one patient ovary was in the inguinal canal, and after its reduction, we proceeded with the operation Unexpectedly. in one patient, right ovarian torsion was detected which was detorsioned, and hernia surgery was performed in the same session. The duration of the operation was 5-35 min (median 15 min) for unilateral and 8-45 min (median 20 minutes) for bilateral hernias. None of these patients developed peroperative and postoperative complications. Follow-up time was minimum 10 months, and maximum 3 years. Recurrence was not detected. DISCUSSION AND CONCLUSION: Burnia technique seems to be effective and safe. The contralateral side and other intra-abdominal pathologies are explored. The cosmetic appearance is its another advantage. The operation time is very short due to the fact that only the hernia sac is cauterized. Comparison of this technique with other laparoscopic techniques is planned in the future study.