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Laparoscopic inguinal hernia repair in children: a single-centre experience over 7 years
Mohan K Abraham1, Abdulrasheed A Nasir, Ramakrishnan Puzhankara
1Department of Pediatric Surgery, Amrita Institute of Medical Sciences and Research Centre, Amrita Lane, Elamakkara P.O., Kochi, India.
Insights
Laparoscopic hernia repair in children is a safe and effective procedure, offering excellent cosmetic results and a low recurrence rate comparable to open surgery. This technique provides clear visualization, ensuring the vas deferens remains untouched.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Evaluation of 209 children undergoing laparoscopic hernia repair over seven years.
- Focus on technical details and clinical outcomes.
Purpose of the Study:
- To assess the feasibility and efficacy of laparoscopic hernia repair in pediatric patients.
- To report technical aspects and clinical results of the procedure.
Main Methods:
- Laparoscopic closure of 284 internal inguinal rings in 209 children (aged 30 days to 15 years).
- Utilized 5-mm and 3-mm instruments for peritoneal access.
- Internal inguinal ring closure performed with nonabsorbable suture.
Main Results:
- No significant intraoperative complications observed.
- Procedure duration averaged 30 minutes (range 15-65 minutes).
- Identified patent contralateral internal rings in 53 children (24.9%).
- Mean follow-up of 30 months with a 2.4% hernia recurrence rate and excellent cosmesis.
Conclusions:
- Laparoscopic hernia repair is a routine procedure in children with surgeon experience.
- Offers clear visualization, preserving the vas deferens.
- Achieves recurrence rates comparable to open repair with superior cosmetic outcomes.
Background:
To evaluate 209 consecutive children who underwent laparoscopic hernia repair over a 7-year period. Technical details and clinical results are reported.
Materials And Methods:
A total of 284 open internal rings were closed laparoscopically in 209 children (142 boys and 67 girls, aged 30 days to 15 years, mean 44 months). One 5-mm and two 3-mm instruments were used to access the peritoneal cavity. A 270° anterolateral peritoneal incision was made. The internal inguinal ring was closed with a nonabsorbable suture.
Results:
There were no significant intraoperative complications. Length of procedure ranged between 15 and 65 minutes with a mean of 30 minutes. Postoperative hospital stay ranged from 1 to 9 days. Thirty children who presented with a right-sided hernia and 23 with a left hernia (total of 53) were found to have a patent contralateral internal ring on laparoscopy. Mean follow-up was 30 months. There were 2.4% hernia recurrences and cosmesis was excellent.
Conclusions:
Laparoscopic hernia repair in children can be a routine procedure with increasing experience and better learning curve of surgeons. There is clear visualization of structures and vas remains untouched. The recurrence rate is comparable to that of the traditional open approach with a superior cosmetic result.