Peer-reviewed article
Extraperitoneal repair using modified single-port mini-nephroscopy for pediatric hydrocele: surgical outcomes in 65 children.
Wang Q, Liu Q ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a surgical case series describing a minimally invasive technique for repairing communicating hydrocele (fluid accumulation around the testicle) in 65 children aged 1.5-8 years. The study reports that the modified single-port nephroscopic procedure was successful in all cases with short operative time, rapid recovery, and no complications observed during follow-up. While the work involves children, it focuses on surgical technique refinement rather than evaluating interventions for child well-being outcomes.
Key points
- All 65 pediatric patients successfully underwent the procedure without conversion to open surgery
- Mean operative time was 8-10 minutes with all children discharged at 24 hours
- Postoperative pain was mild and transient (VAS score 2.1 at 6h, 1.2 at 24h)
- No recurrence, testicular atrophy, or complications observed during 3-18 month follow-up
- Testicular volume and artery resistance index remained stable on ultrasound
Limitations
This is a surgical technique case series without a comparison group, so it cannot determine whether this approach is superior to standard open surgery or other minimally invasive methods. The study does not address broader child well-being outcomes or social determinants of health.
Abstract
Objective The purpose of the study is to introduce our experience of a modified single-port Mini-Nephroscopy technique for the treatment of pediatric hydrocele. Methods In this prospective study, 65 male children (age range: 1.5-8 years) with unilateral communicating hydrocele were enrolled between June 2019 and June 2022. The surgical procedure consisted of high ligation of the patent processus vaginalis performed extraperitoneally using a modified single-port nephroscope introduced through a single umbilical incision, facilitated by custom suture-guiding instruments. The primary outcome measures included testicular volume and testicular artery resistance index (RI), which were evaluated via scrotal ultrasonography preoperatively and at scheduled follow-ups of 1 and 6 months. Results The novel technique was successfully employed in all 65 patients without conversion to open surgery. The mean operative time was remarkably brief (8-10 min), facilitating a 24-hour discharge for all children. Postoperative pain was well-controlled, with mean VAS scores decreasing from 2.1 ± 0.82.1 ± 0.8 at 6 h to 1.2 ± 0.51.2 ± 0.5 at 24 h, indicating only mild and transient discomfort. With a follow-up of 3-18 months, no instances of recurrence, testicular atrophy, or other complications (e.g., knot reactions, iatrogenic ascent) were observed. Conclusion Single-port nephroscopic high ligation holds significant promise for pediatric communicating hydrocele, offering a compelling combination of minimal invasiveness, high operative efficiency, rapid recovery, and an excellent safety profile. These results strongly endorse its consideration as a first-line surgical treatment for this condition.