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Laparoscopic inguinal hernia repair in children
Palanivelu Chinnaswamy1, Vijaykumar Malladi, Kalpesh V Jani
1Coimbatore, Tamil Nadu, India.
Insights
Laparoscopic inguinal hernia repair in children is safe and effective, with a low recurrence rate of 3.1%. This minimally invasive approach offers a reproducible technique for pediatric surgeons.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Laparoscopic Procedures
Background:
- Inguinal hernias are common in children.
- Traditional open repair has potential complications.
- Laparoscopic techniques offer potential advantages.
Purpose of the Study:
- To document the experience and outcomes of laparoscopic inguinal hernia repair in pediatric patients.
- To evaluate the safety, reproducibility, and efficacy of this minimally invasive approach.
Main Methods:
- Ninety-three laparoscopic inguinal hernia repairs were performed in 64 children.
- Hernial sacs were closed using a purse-string suture with 4-0 absorbable material.
- Modifications, including ilio-pubic tract repair, were employed based on intraoperative findings.
Main Results:
- The mean operative time was 25 minutes.
- Contralateral processus vaginalis was patent in 20% of cases.
- The recurrence rate was 3.1%, with successful management of recurrence via laparoscopic ilio-pubic tract repair.
Conclusions:
- Laparoscopic inguinal hernia repair is a safe, reproducible, and technically feasible option for experienced pediatric surgeons.
- Ilio-pubic tract repair is a valuable adjunct for managing dilated internal rings.
- Further long-term follow-up is needed for laparoscopic ilio-pubic tract repair outcomes.
Background:
This study aimed to document the authors' experience with laparoscopic inguinal hernia repair in children.
Methods:
Ninety-three hernia repairs were performed in 64 children. The neck was closed with a purse string suture by using 4-0 absorbable suture.
Results:
Ninety-three indirect inguinal hernial sacs were closed in 64 children. Nine percent of children had an ectopic testis. The mean operating time for laparoscopic ring closure was 25 minutes (range, unilateral 21 to 35; bilateral, 28 to 50). The contralateral processus vaginalis was patent in 20% of children. In 24% of children, the final procedure was modified based on the findings of a dilated internal ring. A laparoscopic ilio-pubic tract repair was done in these cases. Laparoscopic mobilization, orchiopexy followed by ilio-pubic tract repair was done in 9% of children. Scrotal swelling occurred in one child. Hydrocoele occurred in one patient. Recurrence rate was 3.1%.
Conclusion:
Laparoscopic inguinal hernia repair in children can be offered, as it is safe, reproducible, and technically easy for experienced laparoscopic surgeons. Ilio-pubic tract repair may be added in cases with dilated internal ring. Recurrence following laparoscopic ring closure can be managed with laparoscopic ilio-pubic tract repair. The long-term follow-up of laparoscopic ilio-pubic tract repair is awaited.