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Laparoscopic Pediatric Inguinal Hernia Repair; Intracorporeal Purse-String Suture Using Needlescopic 2-mm

Jeong Min Lim1, Hye Kyung Chang1, Sun Jin Park1

  • 1Department of Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.

Journal of Minimally Invasive Surgery
|May 23, 2022
PubMed
Summary

Laparoscopic intracorporeal suture using 2-mm instruments is a safe and feasible technique for pediatric inguinal hernia repair, offering excellent cosmetic outcomes. This minimally invasive approach resulted in low recurrence rates and minimal complications.

Keywords:
Inguinal herniaInguinal ringLaparoscopyPediatricsSuture technique

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Area of Science:

  • Pediatric surgery
  • Minimally invasive surgery
  • Laparoscopic techniques

Background:

  • Pediatric inguinal hernias are common surgical conditions.
  • Minimally invasive approaches offer cosmetic and recovery benefits.
  • Needlescopic instruments (2-mm) minimize abdominal wall damage.

Purpose of the Study:

  • To evaluate the feasibility of laparoscopic intracorporeal suture using 2-mm instruments for pediatric inguinal hernia repair.
  • To assess the safety and cosmetic outcomes of this technique.

Main Methods:

  • Retrospective review of 131 pediatric patients undergoing laparoscopic inguinal hernia repair (March 2011-February 2017).
  • Utilized three trocars: one 5-mm and two 2-mm instruments.
  • Internal ring closure via intracorporeal purse-string suture.
  • Recurrence confirmed by telephone interview.

Main Results:

  • 169 procedures were successfully completed in patients aged 2 months to 14 years.
  • Mean operating times: 42 minutes (unilateral), 46 minutes (bilateral).
  • Low recurrence rate of 2.3% (3/169) over a mean follow-up of 54.6 months.
  • No intraoperative complications, wound issues, or testicular atrophy observed.

Conclusions:

  • Laparoscopic intracorporeal internal ring suture with 2-mm instruments is technically feasible and safe for pediatric inguinal hernias.
  • The technique provides excellent cosmetic results and a low recurrence rate.
  • This approach represents a viable minimally invasive option for pediatric inguinal hernia repair.