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Decreased recurrence rate in the laparoscopic herniorraphy in children: comparison between two techniques
Antonio Marte1, Maria D Sabatino, Micaela Borrelli
1Department of Paediatric Surgery, Second University of Naples, Naples, Italy.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|February 17, 2009
Summary
Adding a lateral incision to inguinal ring suture significantly reduces recurrence rates in pediatric laparoscopic hernia repair. This technique offers a safer, more effective approach to prevent hernias from returning in children.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Laparoscopic herniorrhaphy in children is associated with a high rate of hernia recurrence.
- Existing techniques may not sufficiently address the anatomical factors contributing to recurrence.
Purpose of the Study:
- To evaluate the efficacy of adding a lateral sac incision to the inner inguinal ring suture (IRIS) in reducing hernia recurrence rates compared to standard inner inguinal ring suture (IRS) alone.
- To assess the safety and effectiveness of the IRIS technique in pediatric laparoscopic inguinal hernia repair.
Main Methods:
- Retrospective review of 248 laparoscopic inguinal hernia repairs in 224 children (aged 8 months to 11 years).
- Patients were divided into two groups: IRS (n=123) with W-shaped suture closure of the inner inguinal ring, and IRIS (n=101) with a 1-2 cm lateral sac incision followed by W-shaped suture.
- Follow-up averaged 24 months (range 6-36 months).
Main Results:
- The IRS group had a recurrence rate of 3.76% (5 of 133 hernias).
- The IRIS group showed no recurrences (0 of 101 patients).
- The difference in recurrence rates between the two groups was statistically significant (P < 0.05).
Conclusions:
- The IRIS technique, involving a lateral incision of the peritoneum followed by a W-shaped suture, is a safe and effective method for preventing hernia recurrence in pediatric laparoscopic surgery.
- This modified approach significantly improves outcomes compared to the sole use of inner inguinal ring suture.
