Laparoscopic preperitoneal injection of polyacrylamide gel - a new method for the treatment of inguinal hernias: preliminary results of an experimental study
Introduction. Inguinal herniotomy is the commonest intervention in pediatric surgery. Laparoscopic suturing of the inguinal ring are easy to perform by various methods with a small number of relapses. This study was aimed to evaluate results of laparoscopic preperitoneal injection of 3D gel for the closure of the internal inguinal ring in laboratory animals. Materials and methods. Peritoneoscopy under general anesthesia was performed in 12 Chinchilla male rabbits (body weight 12001400 g). The endoscope was introduced into mesogastrium to identify inguinal rings on both sides. The Tuohy needle with a syringe containing the DAM+ bulk polymer (3D polyacrylamide gel with silver ions (Argiform, Bioform)) was introduced preperitoneally The implant was placed in the inguinal ring opening to cover spermatic cord structures. The rabbits were extubated after gel administration. The second laparoscopy was performed in 6 months to examine internal inguinal rings. Results. The postoperative period was uneventful. Second laparoscopy did not reveal repeated opening of internal inguinal rings. In all animals, precise placement of the polymer agent and adequate coverage of testicular vessels was achieved. Conclusion. The study showed that the use of a biopolymer yields good long-term outcomes of surgery and ensures stable closure of internal inguinal rings in rabbits. It may be hoped that bulk polymers can be used to treat inguinal hernias in children after additional studies involving animals and humans.