In the present study, we introduced a modified trocar puncturing method and evaluated its clinical application in laparoscopic high ligation of vaginal process in children. A total of 62 communicating hydrocele children were treated by high ligation of vaginal process under laparoscopy. Among them, 32 children underwent laparoscopic high ligation of vaginal process with traditional trocar puncturing method (traditional group) and the remaining 30 children underwent trocar puncturing with a modified method (modified group). In the modified group, after a 5 mm trocar was inserted, other trocars with a puncturing needle pierced through skin, subcutaneous tissues, muscular layers and peritoneumandwere further inserted in a certain direction and angle. The puncturing time, total operating time and complications were compared between both groups. All operations were successfully performed in both groups. The mean puncturing time (11 ± 2.7 min) in the traditional group was significantly longer than that (5.2 ± 1.0 min) in the modified group (t = 11.07, P < 0.05). The total operating time in the traditional group was significantly longer than that in the modified group (24 ± 4.0 min vs. 19 ± 3.1 min, t = 5.48, P < 0.05). No intra-abdominal organ injuries, postoperative scrotal hematoma or wound infections were found in both groups. There was no significant difference in postoperative administration of analgesics between two groups (3.8 ± 1.3 mg vs. 3.6 ± 1.2 mg, t = 0.63, P > 0.05). Mean length of stay in both groups was 2.3 ± 0.6 and 2.2 ± 0.5 days, respectively (t = 0.71, P > 0.05). Expect that 2 patients lost follow-up, the remaining 60 patients were followed up for 3 - 12 months and no hydrocele recurrence, incisional hernia or testicular atrophy occurred. This modified trocar puncturing method can save puncturing time and total operating time, with improved safety of trocar puncturing theoretically in children. This method is worthy of application in more extensive clinical practice.
Key words: Hydrocele, laparoscopy, children, trocar puncturing.
Copyright © 2020 Author(s) retain the copyright of this article.
This article is published under the terms of the Creative Commons Attribution License 4.0