Single port treatment of epigastric hernias using an operating scope

Background Epigastric hernias are small (5–20 mm) supraumbilical defects generally presenting with a single site defect. Traditionally, the repair of an epigastric hernia involves a transverse incision, dissection and wound readaptation leaving visible scars. We present our experience with a minimally invasive single port technique of supraumbilical hernia closure using an operating scope. Methods Between January 2019 and September 2020, a total of 24 epigastric herniorrhaphies were performed in 18 children (10 boys, 8 girls). Fourteen patients had a single site defect and 4 presented with multiple site defects (2 patients with double defects and 2 patients with triple defects). All patients were operated by the “SU.PER.LAP” technique (a modified laparoscopic-assisted percutaneous suture technique). Results The mean surgical time was 14 min (12–22 min). Average age of the patients was 5 years (13 months–12 years). Twelve patients had associated umbilical hernias, 5 boys had intraoperative diagnosis of unilateral inguinal hernia and 4 patients with multiple epigastric defects; all defects being corrected in the same surgical session. Mean follow-up duration was 12 months (2 months–21 months). There was no intraoperative or postoperative complication, and no recurrences. Conclusions “SU.PER.LAP” is a safe and feasible technique with comparable result to the open approach. The use of an operating scope with working channel permits repair using the minimally invasive approach, and the possibility to repair multiple defects in the same surgical session, avoiding the need for additional ports. Other hernias, if detected, can be repaired at the same time avoiding multiple future surgeries, while at the same time achieving good cosmesis.