Laparoscopic-assisted percutaneous herniorrhaphy as an alternative to open surgery technique in farm swines

Przemysław Prządka; Bartłomiej Liszka; Agnieszka Antończyk; Piotr Skrzypczak; Zdzisław Kiełbowicz; Dariusz Patkowski

doi:10.1371/journal.pone.0256890

Laparoscopic-assisted percutaneous herniorrhaphy as an alternative to open surgery technique in farm swines

PLoS One. 2021 Sep 3;16(9):e0256890. doi: 10.1371/journal.pone.0256890. eCollection 2021.

Authors

Przemysław Prządka¹, Bartłomiej Liszka¹, Agnieszka Antończyk¹, Piotr Skrzypczak¹, Zdzisław Kiełbowicz¹, Dariusz Patkowski²

Affiliations

¹ Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland.
² Department of Paediatric Surgery and Urology, Medical University of Wroclaw, Wroclaw, Poland.

Abstract

Background: Despite numerous experimental studies presenting laparoscopic treatment of inguinal hernia in a pig model so far no described technique has been used in clinical patients of this species. Minimal invasiveness and the simplicity of closure of the inguinal canal using the Percutaneous Internal Ring Suturing (PIRS) technique makes it the world's first technique for laparoscopic treatment of inguinal hernia in pigs as clinical patients.

Aim: This study aims to assess the applicability and effectiveness of the laparoscopic PIRS technique in the treatment of inguinal hernia in pigs as clinical patients and to compare the PIRS technique with the open surgery technique, which is currently being used.

Methods: The study was conducted on 22 non-castrated male pigs with inguinal hernia (clinical patients), divided into two equal groups: PIRS and open surgery (OS). In the PIRS group, the inner inguinal ring was closed with an optical trocar inserted at the umbilicus level and an injection needle with a suture material inserted percutaneously over the inguinal canal. The suture material was threaded through the inner inguinal ring and then tied, leaving the knot under the skin. As a result to this the inguinal canal was closed. In the OS group the procedure was performed with open access above the inguinal canal where, after dissection of the vaginal processus and reducing the contents of the hernia to the abdominal cavity, it was ligated as close to the inguinal canal as possible, and the wound was then closed in layers.

Results: All operated pigs returned to full fitness immediately after recovery from anesthesia. There was one case of hernia recurrence in the PIRS group. In the OS group all the operated pigs had a temporary swelling of the postoperative wound and the scrotum on the side of the operated inguinal hernia, which was not found in the PIRS group.

Conclusions: The effectiveness of the PIRS technique is comparable to that of open surgery. Considering the simplicity of the PIRS procedure and its minimal invasiveness, this technique may be used as an alternative to the open technique in the treatment of inguinal hernias in pigs not subjected to surgical castration.

Publication types

Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Animals
Disease Models, Animal
Hernia, Inguinal / pathology
Hernia, Inguinal / surgery*
Herniorrhaphy / methods*
Inguinal Canal / pathology
Inguinal Canal / surgery*
Laparoscopy / methods*
Male
Swine
Treatment Outcome

Grants and funding

The costs of publication were financed under the Leading Research Groups support project from the subsidy increased for the period 2020–2025 in the amount of 2% of the subsidy referred to Art. 387 (3) of the Law of 20 July 2018 on Higher Education and Science, obtained in 2019. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The funders role was only to pay publication fees after the manuscript acceptance.