Laparoscopic inguinal hernia repair; experience with 874 children
Related Experiment Video
Updated: May 2, 2026
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Rafik Shalaby1, Maged Ismail1, Abdelhady Samaha1
1Department of Pediatric Surgery, Al-Azhar University Hospitals, Cairo, Egypt.
Insights
Laparoscopic inguinal hernia repair (LIHR) in children is a safe and effective alternative to open surgery. This study shows comparable or improved outcomes, including reduced operative time and recurrence rates, after mastering the technique.
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.
Background:
Laparoscopic inguinal hernia repair (LIHR) in children has become an alternative to the open procedure. It is gaining popularity with more and more studies supporting its feasibility, safety, and efficacy. This is a retrospective study to present our experience with children who underwent LIHR.
Patients And Methods:
A total of 1184 inguinal hernias were repaired laparoscopically in 874 children. They were 703 boys and 171 girls. Their mean age was 2.9 ± 2.1 years (range, 6-108 months). Six-hundred and twenty four opened internal inguinal rings (IIRs) were closed by transperitoneal purse string suture technique (TPP) and 560 opened IIRs were closed by percutaneous purse string suture with lateral umbilical ligament enforcement using Reverdin Needle (RN) technique.
Results:
All cases were completed laparoscopically without conversion. There were no serious intraoperative complications. Mean operating time, in TPP technique, was 15 ± 2.3 minutes for unilateral and 20 ± 1.7 minutes for bilateral inguinal hernia, while the mean operating time, in RN technique, was 8.7 ± 1.18 minutes for unilateral and 12.35 ± 2 minutes for bilateral hernia repair. The contralateral patent processus vaginalis (PPV) was present in 176 (20% of cases). Follow-up to date is 10-140 months (mean 80 ± 2.1 months). In the early stage of this study, the recurrence rate was 1.13%. In the last 450 cases, no recurrence occurred. Hydroceles occurred in 0.58% and no testicular atrophy or iatrogenic ascent of the testis.
Conclusions:
LIHR can be a routine procedure with results comparable to those of open procedures. Both recurrence and operative time are nearly equal or even less than that for the open procedure after gaining a learning curve and modifications of the techniques.
More Related Videos
09:00Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
Published on: November 12, 2021
03:57Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
Published on: July 8, 2025