Laparoscopic pediatric inguinal hernia repair: a controlled randomized study

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Surgical Innovation

Background:

• Inguinal hernia repair is a common pediatric surgical procedure.
• Laparoscopic techniques for pediatric inguinal hernia repair are still under investigation.
• Various laparoscopic methods exist, necessitating comparative studies.

Purpose of the Study:

• To compare two laparoscopic techniques for congenital inguinal hernia (CIH) repair in children.
• Evaluate intracorporeal purse-string suture ligation versus sac disconnection with suturing.
• Assess operative time, recurrence rates, and postoperative complications.

Main Methods:

• Prospective randomized controlled study of 132 pediatric patients over 2 years and 8 months.
• Group I (n=66): Laparoscopic intracorporeal purse-string suture ligation of the hernia sac at the internal inguinal ring (IIR), leaving the sac intact.
• Group II (n=66): Laparoscopic disconnection of the hernia sac at the IIR with proximal suturing and peritoneal closure.

Main Results:

• 132 patients (157 hernia defects) aged 6 months to 3 years included.
• No significant difference in intraoperative complications or hospital stay between groups.
• Significant differences observed in operative time and postoperative complications, favoring sac disconnection.

Conclusions:

• Laparoscopic repair with hernia sac disconnection and peritoneal closure is a safe and feasible pediatric CIH treatment.
• This method shows a reduced recurrence rate compared to the purse-string technique with an intact sac.