Technical innovation and clinical effects of single-port laparoscopy for pediatric indirect inguinal hernia using needle graspers

Abstract

Objective: To explore the technical innovation, feasibility and clinical efficacy of single-port laparoscopic high ligation of the hernia sac in pediatric indirect inguinal hernia using needle graspers.

Methodology: A retrospective analysis was conducted on the clinical data of 403 children with unilateral indirect inguinal hernia treated at Hebei Children’s Hospital from January 2022 to December 2025. Based on the surgical technique used, these children were divided into the grasper group (n=198, who underwent trans umbilical single-port laparoscopic high ligation of the hernia sac using needle graspers) and the conventional group (n=205, who underwent conventional two-port laparoscopy) and the perioperative indicators, postoperative pain scores, incidence of complications, recurrence rates and cosmetic satisfaction were compared between the two groups.

Results: The operation time for the grasper group was slightly longer than that of the conventional group (27.74±9.60 min vs. 24.54±9.69 min, P=0.001). However, the FLACC pain score at 24 h postoperatively was significantly lower in the grasper group (3.26±0.67 vs. 4.48±0.57, P<0.001), with an earlier time to first ambulation (5.48±0.58 h vs. 7.47±0.56 h, P<0.001). Meanwhile, there were no significant differences between the two groups in terms of intraoperative blood loss, length of hospital stays, incidence of complications, or recurrence rates (P>0.05). Additionally, the cosmetic satisfaction score in the grasper group was markedly higher than in the conventional group (8.48±0.58 vs. 7.35±0.58, P<0.001).

Conclusion: The application of single-port laparoscopy for pediatric indirect inguinal hernia using needle graspers is safe and feasible. Despite the slightly longer operation time, it offers substantial advantages in mitigating postoperative pain, promoting early ambulation and improving cosmetic outcomes.