Document Detail


Laparoscopic inguinal hernia repair does not impair testicular perfusion.
MedLine Citation:
PMID:  18206470     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Laparoscopic inguinal hernia repair techniques close the internal ring with a suture. Concern has been raised whether or not the testicular vessels are compromised with this technique. This study was undertaken to evaluate pre- and postoperative testicular perfusion and to compare it with healthy controls. PATIENTS AND METHOD: Sixty-five boys (aged 6 weeks to 11 years; median, 1.4 years) with unilateral (n = 52) or bilateral (n = 13) inguinal hernias were treated laparoscopically. Testicular perfusion was measured using a recently developed neuromonitoring device (O2C; LEA Medizintechnik GmbH, Giessen, Germany), which combines light spectroscopy and laser Doppler technique. An optical probe was placed on the surface of each scrotal pouch for measurements at 2 depths (2 and 8 mm). Measurements involved oxygen (O(2)) saturation at the venous end of capillaries, the amount of hemoglobin within microvessels, the blood flow within microcirculation, and the velocity of the blood in microcirculation. Measurements were conducted before and after anesthesia, before and after surgery, and 6 weeks later. Twenty-one healthy boys of similar ages served as controls. RESULTS: Measurements at 2-mm depth were unreliable. At 8-mm depth, the oxygen saturation of hemoglobin was between 62% and 75% (hypoxia would be <10%). The relative blood flow was between 160 to 235 arbitrary units, better than in healthy awake controls. Values were solely influenced by the administered fraction of inspired oxygen. Relative hemoglobin volume of the testes and blood flow velocity remained unchanged after surgery. Values were also normal when measured during early and long-term follow-up. CONCLUSION: Laparoscopic inguinal hernia repair using suture closure of the internal inguinal ring does not impair testicular perfusion.
Authors:
Felix Schier; Salmai Turial; Thomas Hückstädt; Klaus Ulrich Klein; Tanja Wannik
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  43     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-21     Completed Date:  2008-02-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  131-5; discussion 135     Citation Subset:  IM    
Affiliation:
Department of Pediatric Surgery, University Medical <schier@kinderchir.klinik.uni-mainz.de>
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MeSH Terms
Descriptor/Qualifier:
Case-Control Studies
Child
Child, Preschool
Cohort Studies
Follow-Up Studies
Hernia, Inguinal / diagnosis,  surgery*
Humans
Infant
Intraoperative Complications / prevention & control*
Laparoscopy / adverse effects,  methods*
Male
Oxygen Consumption / physiology
Probability
Reference Values
Regional Blood Flow / physiology
Risk Assessment
Suture Techniques
Testis / blood supply*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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