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Laparoscopic hernia repair in children by the hook method: a single-center series of 433 consecutive patients
Yuk Him Tam1, Kim Hung Lee, Jennifer Dart Yin Sihoe
1Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. pyhtam@hotmail.com
Insights
The hook method for laparoscopic hernia repair in children significantly reduces recurrence rates. This technique offers a safe and effective alternative to traditional open surgery, with minimal complications.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Procedures
Background:
- High recurrence rates in pediatric laparoscopic hernia repair using intracorporeal suturing.
- Need for improved techniques to address concerns with current methods.
Purpose of the Study:
- Evaluate the effectiveness of the hook method for laparoscopic hernia repair in children.
- Assess its ability to close hernia sacs without tension or skip areas.
Main Methods:
- Retrospective review of 433 children undergoing laparoscopic hernia repair with the hook method.
- Data collected from July 2004 to June 2007.
Main Results:
- 572 repairs performed in children aged 1 week to 15 years.
- Low recurrence rate of 0.35% (2 out of 572 repairs) at a median 20-month follow-up.
- Conversion rate of 1.04% and no serious complications reported.
Conclusions:
- Laparoscopic hernia repair using the hook method is a viable alternative to open herniotomy in pediatric patients.
- The technique is effective in reducing recurrence and is associated with a low complication rate.
Background:
The relatively high recurrence rate reported in laparoscopic hernia repair in children using intracorporeal suturing technique remains a concern. We aimed to investigate the effectiveness of the hook method during hernia repair that allows extraperitoneal passage of suture to close the hernia sac without creating any tension or skip areas and does not require laparoscopic suturing skills.
Methods:
A retrospective review was conducted on 433 consecutive children who underwent laparoscopic hernia repair using the hook method by 1 of 4 surgeons from July 2004 to June 2007.
Results:
A total of 572 successful laparoscopic hernia repairs were performed among the 433 children with an age range of 1 week to 15 years (mean = 56 months). Conversion rate was 1.04%. Contralateral patent processus vaginalis was found in 26.8%. Mean operating time was 23.8 and 40.2 minutes for unilateral and bilateral repair, respectively. At a median follow-up of 20 months, there were 2 recurrences (0.35%), 2 hydroceles, 1 ascending testis, and 1 instance of testicular atrophy. No serious complications were associated with the procedure.
Conclusions:
Medium-term results suggest that laparoscopic hernia repair with the hook method is a sound alternative to open herniotomy in children.
