Laparoscopic inguinal hernia repair; experience with 874 children

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Laparoscopic inguinal hernia repair (LIHR) is emerging as a viable alternative to traditional open surgery in pediatric patients.
• Growing evidence supports the feasibility, safety, and efficacy of LIHR in children.
• This retrospective study details the experience with LIHR in a pediatric cohort.

Purpose of the Study:

• To evaluate the outcomes of laparoscopic inguinal hernia repair (LIHR) in a pediatric population.
• To compare the efficacy and safety of two distinct LIHR closure techniques.
• To assess recurrence rates, operative times, and complication profiles associated with LIHR.

Main Methods:

• Retrospective analysis of 1184 LIHR procedures in 874 children (mean age 2.9 years).
• Two closure techniques were employed: transperitoneal purse string suture (TPP) and percutaneous purse string suture with Reverdin Needle (RN) technique.
• Data collected included operative time, conversion rates, complications, and recurrence rates.

Main Results:

• All procedures were completed laparoscopically without conversion; no serious intraoperative complications occurred.
• The RN technique demonstrated significantly shorter operative times (unilateral: 8.7 min; bilateral: 12.35 min) compared to TPP (unilateral: 15 min; bilateral: 20 min).
• Overall recurrence rate was 1.13%, with no recurrences in the final 450 cases. Hydroceles occurred in 0.58%; no testicular atrophy or ascent was noted.

Conclusions:

• Laparoscopic inguinal hernia repair (LIHR) can be routinely performed in children with outcomes comparable to open procedures.
• Mastery of the learning curve and technique modifications lead to reduced operative times and recurrence rates.
• LIHR offers a safe and effective treatment option for pediatric inguinal hernias.