Comparative research on efficacy of needle grasper and mobile retractor-assisted laparoscopic high ligation of hernia sac in treatment of pediatric indirect inguinal hernia

Abstract

Objective: To compare the clinical efficacy of needle grasper and mobile retractor-assisted laparoscopic high ligation of the hernia sac in the treatment of pediatric indirect inguinal hernia.

Methodology: A retrospective analysis was conducted on 531 children with unilateral primary indirect inguinal hernia at Hebei Children’s Hospital who were admitted from January 2021 to December 2025. These children were divided into the grasper group (n=198) and the retractor group (n=333) according to the main instruments used for dissecting and ligating the neck of hernia sac during the surgery. Specifically, perioperative indicators, levels of inflammatory factors, complications, recurrence rate and other indicators were compared between the two groups.

Results: The needle grasper group showed a significantly shorter operation time than the retractor group (27.74±9.60 min vs. 29.94±7.49 min, P=0.004) and the pain score at 24 h postoperatively was lower (3.26±0.67 vs. 3.99±0.80, P<0.001), along with a smaller increase in inflammatory factors such as IL-6 and CRP postoperatively (P<0.05). Additionally, no statistically significant differences were observed in intraoperative blood loss, incidence of early complications, detection rate of contralateral occult hernia and long-term recurrence rate between the two groups (P>0.05).

Conclusion: Both needle grasper and mobile retractor-assisted laparoscopic high ligation of the hernia sac are safe and effective in the treatment of pediatric indirect inguinal hernia. However, needle graspers are superior in shortening the operation time and mitigating postoperative pain and inflammatory response, demonstrating better minimally invasive performance.