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Laparoscopic repair of sliding inguinal hernia in female children
Tomohiro Ishii1, Takeo Yonekura2, Katsuji Yamauchi2
1Department of Pediatric Surgery, Kindai University Nara Hospital, 1248-1, Otoda-cho, Ikoma-shi, Nara, 630-0293, Japan. t_ici0314@yahoo.co.jp.
Insights
Laparoscopic percutaneous extraperitoneal closure (LPEC) is a safe and feasible method for female pediatric sliding inguinal hernias, but requires caution with fallopian tube involvement.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Sliding inguinal hernias in female children present unique surgical challenges.
- Laparoscopic techniques are increasingly utilized for pediatric hernia repair.
Purpose of the Study:
- To assess the safety and feasibility of laparoscopic percutaneous extraperitoneal closure (LPEC) for sliding inguinal hernias in female pediatric patients.
- To identify potential complications and outcomes associated with this approach.
Main Methods:
- Retrospective review of 14 female pediatric patients with sliding inguinal hernias who underwent LPEC between 2006 and 2015.
- Analysis of surgical procedures, complications, and recurrence rates.
Main Results:
- LPEC was generally safe and feasible, with most cases managed successfully.
- Seven patients required ovarian reduction; five had severe fallopian tube sliding into the inguinal canal.
- One case with fallopian tube sliding recurred after simple LPEC, necessitating further repair. Four others required extended operative time or conversion due to fallopian tube involvement.
Conclusions:
- LPEC is a safe and feasible option for sliding inguinal hernias in female children, excluding cases with significant fallopian tube sliding.
- Fallopian tube sliding necessitates careful surgical planning, potentially requiring additional procedures or conversion to an open inguinal approach.
Purpose:
To evaluate the safety and feasibility of laparoscopic repair of sliding inguinal hernia in female children.
Methods:
Laparoscopic percutaneous extraperitoneal closure (LPEC) was performed in 482 female inguinal hernia children between 2006 and 2015. Fourteen of these patients were associated with sliding inguinal hernia, and these 14 patients were enrolled and reviewed retrospectively.
Results:
The mean age and the body weight at the operation was 9.6 months and 7.8 kg. Seven patients required the reduction of the ovary under general anesthesia. Laparoscopy, however, revealed that five patients had severe sliding of fallopian tube into the inguinal canal. One of these five patients received a simple LPEC, but developed the recurrence due to the low ligation of the hernia sac, and needed the second hernia repair under inguinal approach. Other four patients with fallopian tube sliding required the dissection of the fallopian tube and peritoneal repair, or the conversion to inguinal approach; therefore they had longer surgical time compared to those without fallopian tube sliding.
Conclusion:
LPEC is safe and feasible for the sliding inguinal hernia repair except the cases with fallopian tube sliding. Patients with fallopian tube sliding required additional procedure or conversion to inguinal approach.
