Laparoscopic inguinal hernia repair in bladder exstrophy, a new modified solution to an old problem: A cohort study

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Urology

Background:

• Inguinal hernias are common in children with bladder exstrophy.
• Open repair of these hernias has a high recurrence rate (15%-22%).
• Laparoscopic techniques offer a potential alternative for managing these complex cases.

Purpose of the Study:

• To evaluate the initial experience with a specific laparoscopic technique for inguinal hernia repair in children with repaired bladder exstrophy.
• To assess the feasibility and outcomes of this novel laparoscopic approach.

Main Methods:

• A retrospective review of laparoscopic inguinal hernia repairs performed between July 2019 and July 2020.
• A technique involving internal inguinal ring closure with non-resorbable suture and transversalis fascia reinforcement.
• Peritoneal purse-string closure and evaluation of outcomes over a 14-month follow-up.

Main Results:

• Five male patients with repaired bladder exstrophy underwent laparoscopic inguinal hernia repair.
• Three patients had bilateral hernias, and two had unilateral hernias.
• All patients experienced an uneventful recovery, were discharged within 24 hours, and had no complications or recurrences during follow-up.

Conclusions:

• Laparoscopic inguinal hernia repair, using this specific technique, is a safe and effective alternative for children with bladder exstrophy.
• The technique demonstrated no recurrence, suggesting its potential to overcome the challenges of open repair.