Laparoscopic hernioraphy: a better approach for recurrent hernia in boys?

We aimed to compare laparoscopic hernia repair and open hernia repair in recurrent cases after first open repair according to the length of time taken to perform the procedure.

Between November 2009 and December 2011, the medical records of 26 male paediatric patients who were treated with laparoscopic surgery (with Schier's intracorporal "N" suture closure) and open surgery (with high ligation technique) in our institution for recurrent inguinal hernia were reviewed for the length of the operative time and post-operative complications retrospectively. Thirteen cases operated with laparoscopic repair were regarded as Group 1 and other 13 cases operated with the open high ligation repair were regarded as Group 2. All recurrent hernia cases had been performed in other hospitals with the open high ligation technique previously.

Thirteen internal inguinal ring closures in Group 1 were performed laparoscopically. In Group 2, 13 cases underwent open high ligation repair. Comparing the laparoscopic and open-repair techniques in the recurrent cases (Group 1 vs. Group 2; 32.36 vs. 61.07 min, respectively) showed that the length of the operation time was much shorter in laparoscopic repair group (Group 1) than open repair group (Group 2). A statistically significant difference was also observed (p = 0.001). No post-operative testicular atrophy or recurrence was seen until present time in all groups.

We propose that laparoscopic repair in recurrent childhood inguinal hernia cases, developed after open repair, avoids entering a fibrotic inguinal canal, making the procedure easier and shorter. Laparoscopic herniorrhaphy is a good alternative option in recurrent childhood hernia.