Comparison of laparoscopic percutaneous internal ring suturing method and open inguinal hernia repair in children...

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Hernia Repair

Background:

• Laparoscopic inguinal hernia repair in infants younger than 3 months remains controversial.
• Open repair is often considered the gold standard, but its limitations in this age group are being re-evaluated.

Purpose of the Study:

• To assess the safety and feasibility of laparoscopic percutaneous internal ring suturing in infants under 3 months.
• To compare recurrence and complication rates of this laparoscopic technique with traditional open repair.

Main Methods:

• A retrospective study of 140 infants under 3 months undergoing inguinal hernia repair between 2016-2019.
• Patients were divided into two groups: laparoscopic percutaneous internal ring suturing (Group 1, n=85) and open surgery (Group 2, n=55).
• Comparison of operative durations, intraoperative and postoperative complications, and recurrence rates between the groups.

Main Results:

• Operative times were significantly shorter for laparoscopic repair (Group 1) compared to open repair (Group 2) for both unilateral and bilateral cases (p <0.0001).
• Recurrence rates were similar between groups (2 in each, p>0.05).
• No intraoperative complications occurred. One major postoperative complication (iatrogenic undescended testis) occurred in Group 2, none in Group 1. Laparoscopic repair identified bilateral hernias in 47% of initially unilateral cases.

Conclusions:

• Laparoscopic percutaneous internal ring suturing is a favorable technique for infants under 3 months, offering reduced operative time.
• The laparoscopic approach enhances the detection of contralateral patent processus vaginalis or asymptomatic contralateral inguinal hernias.
• This minimally invasive method demonstrates safety and feasibility, potentially challenging the gold standard status of open repair in this pediatric population.