Background and Objectives: Despite numerous described techniques, laparoscopy has yet to replace open surgery as the gold standard for inguinal hernia (IH) repair in children. This may be due to many variables, including the lack of long-term follow-up and concern for increased recurrence. In this study, we present our long-term follow-up data on children undergoing percutaneous internal ring suturing (PIRS) for IH repair. Materials and Methods: This retrospective cohort study included children who underwent PIRS for IH between May 2013 and May 2021 at three tertiary care institutions, with at least three years of follow-up. Age at surgery, side of IH, presence of contralateral patent processus vaginalis, surgical and anesthesia time, and complications were noted. Parents were contacted to enquire about long-term complications, such as recurrence. Results: Long-term follow-up (average 6.9 ± 2.3 years) was available for 714 patients. For unilateral and bilateral procedures, the average surgical time was 13.6 ± 5.4 and 19.9 ± 3.0, and the average anesthesia time was 27.7 ± 12.9 and 33.9 ± 14.1 min, respectively. Complications were seen in 0.84% of patients and 1.2% of procedures, and recurrence was observed in 0.98% of patients and 0.78% of procedures. Conclusions: Our study, with a nearly 7-year follow-up, provides substantial evidence that PIRS is a safe and effective technique for IH repair in children, with low recurrence and complication rates. Despite the study’s retrospective nature and limited sample size, it contributes valuable data supporting the use of PIRS in pediatric IH repair.

Integrin αIIbβ3 is the predominant receptor for fibrinogen which mediates platelet aggregation, an important step in hemostasis and thrombosis. Several mutations have been reported in the genes encoding αIIb and β3 subunits among patients with Glanzmann thrombasthenia, of which 177 are in the β-propeller domain. The two subunits form a heterodimer at the interface between β-propeller and β-I domains of αIIb and β3, respectively with their stability critical for intracellular trafficking, surface expression, and ligand binding. Our study was aimed at retrieving the β-propeller mutations from various databases and studying structural variations due to select mutations upon interaction with fibrinogen using molecular docking and molecular dynamics. Mutations were studied for their impact on phenotypic severity, structural stability, and evolutionary conservation. Molecular docking analysis and molecular dynamics simulations were carried out for αIIb-β3 complexes as well as αIIbβ3-fibrinogen complexes; in particular, E355K structure had more deviations, fluctuations, and other changes which compromised its structural stability and binding affinity when compared to both wild-type and G401C structures. Our comprehensive in silico analysis clearly reiterates that mutations in the β-propeller are not only responsible for structural changes in this domain but also have implications on the overall structure and function of integrin αIIbβ3.

Appropriateness of Pediatric Surgical Consultations from the Emergency Department: A 2-Center Study - Article abstract #951263

Objective: The Pilonidal Sinus (PS) is a pathology of the gluteal cleft that occurs with acute or chronic infection. This study aimed to report the evaluation of five-year experience with 50 patients’ data outcomes of crystallized phenol in pilonidal sinus treatment (CP) pediatric age group. Methods: This retrospective study included 50 patients who underwent CP between 2017 and 2023 years. Patient demographics, operative data, follow-up findings, complications, and recurrence data were also evaluated. Results: Fifty patients (female:31, male:19), mean of age 15,4 years. Hirsutism was diagnosed in 10 female patients (20%). Sixteen (32 %) patients had a family history of PS. Five patients had a smoking habit history (%10). The form of anesthesia was local anesthesia in eight patients (16%), sedation and local anesthesia in 27 patients (54%), and spinal anesthesia in 15 patients (30%). The average duration of the procedure was 13,8 min (10–22 minutes). The mean postoperative leakage time were 6,6 days. Complications were observed in five patients. (10%). Recurrence was observed in three patients (6%). The overall cure rate is 94%. Conclusion: The CP procedure should be used as the first choice, especially in adolescents, compared to the primary method in PS, such as total sinus excision, due to its minimally invasive, painless, low risk of recurrence, and very short postoperative recovery time.

Introduction: Percutaneous internal ring suturing (PIRS) method is an effective minimally invasive laparoscopic method that was preferred for indirect hernia repair in children. Purpose: The aim of this study is to report the evaluation of surgical results in our PIRS series modified with finer needle and suture with the diagnosis of indirect inguinal hernia, communicating hydrocele and incarcerated inguinal hernia. Methods: This was a retrospective study that included children aged 3 months to 12 years who underwent PIRS technique due to inguinal hernia between 2017 and 2022. Per-operative findings, surgical time, follow-up findings, complications, and recurrence data were evaluated. Results: One hundred patients underwent a total of 129 PIRS procedures. Right inguinal hernias were diagnosed in 63 (63%) of the patients (1 communicating hydrocele and 1 recurrent inguinal hernia). One communicating hydrocele and one recurrent inguinal hernia were present on the left side of 32 (32%) patients. Five patients were diagnosed bilaterally (one incarcerated hernia). 24 patients (29%) with no symptoms were found to have contralateral hernias: 11 on the right (45%) and 13 on the left (55%) side. The average duration of surgery for unilateral PIRS was 13.5 minutes and bilateral PIRS was 24.3 minutes. Average follow-up duration was nine months. There were complications in nine patients (9%). Recurrence was observed in 3 (or 3%) of 100 (or 100) patients. Conclusion: PIRS is a simple and safe alternative to open hernia repair in terms of surgical outcomes for the management of inguinal hernia in children.

This study aimed to evaluate Turkish parents' perceptions and attitudes regarding the appropriate age for circumcision, practice conditions, and procedural indications across different regions of Turkey. This cross-sectional survey study was conducted between March 2023 and March 2025 across urology and pediatric surgery departments in seven distinct regions of Turkey. A total of 637 literate parents (aged ≥ 18) completed a voluntary 16-question online survey via a URL or QR code. Subgroup analysis was performed for parents whose sons had already undergone circumcision (n = 404). Data regarding demographics, circumcision preferences, and information sources were analyzed using descriptive statistics and Chi-square tests. The majority of parents (95.1%) considered circumcision necessary, primarily citing religious (77.7%) and medical (63.8%) reasons. Overall, 76% of participants stated that circumcision should ideally occur outside the psychologically sensitive period (PSP; ages 2-6). Among the 404 parents with already-circumcised sons, 41.1% (n = 166) reported that the procedure was performed during the PSP (ages 2-6). Awareness of the non-PSP increased significantly with higher parental education levels (p < 0.001). Regarding practice, specialists were preferred (pediatric surgeons 54.4%; pediatric urologists 46.3%), and the operating room was identified as the safest setting by 91.7% of respondents. Local anesthesia was the most preferred method (51.6%). Despite high awareness regarding specialist qualifications and clinical settings, a significant "knowledge-practice gap" exists concerning the timing of circumcision. Clinicians should proactively counsel parents regarding the psychological risks associated with the PSP, and public health strategies must move beyond general awareness to provide targeted guidance that ensures optimal timing in circumcision.