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Approach to concurrent inguinal hernias during laparoscopic appendectomy for early appendicitis
Sabriye Dayı1, Meryem Anayurt2, Fatma Çınar2
1Department of Pediatric Surgery, University of Health Sciences, Bursa City Hospital, Bursa, Türkiye. sabriye.dayi@sbu.edu.tr.
Insights
Concurrent inguinal hernias during laparoscopic appendectomy in children can be managed. The Burnia technique demonstrated safety and efficacy in symptomatic cases, with no postoperative complications or recurrences observed.
Area of Science:
- Pediatric Surgery
- Laparoscopic Surgery
- Hernia Repair
Background:
- Concurrent inguinal hernias present a surgical challenge during pediatric laparoscopic appendectomy.
- Early identification and management are crucial for optimal patient outcomes.
Purpose of the Study:
- To present a standardized approach for managing inguinal hernias identified during laparoscopic appendectomy in children.
- To evaluate the safety and efficacy of the Burnia technique for hernia repair in this context.
Main Methods:
- Retrospective review of pediatric patients (0-18 years) undergoing laparoscopic appendectomy between July 2019 and December 2022.
- Evaluation of clinical findings, surgical procedures, and outcomes for cases with concurrent inguinal hernias.
Main Results:
- 293 laparoscopic appendectomies were performed; 5 cases (1.7%) had patent processus vaginalis.
- Two symptomatic cases underwent laparoscopic hernia repair using the Burnia technique.
- No postoperative complications or recurrences were noted in the repaired cases.
Conclusions:
- The Burnia technique is a safe and effective option for repairing symptomatic inguinal hernias incidentally found during laparoscopic appendectomy for early appendicitis.
- This approach minimizes the need for separate surgical interventions.
Purpose:
Concurrent inguinal hernia can be a challenge for a pediatric surgeon during a laparoscopic appendectomy in children. We aimed to present our approach to inguinal hernias seen during laparoscopic appendectomy.
Methods:
In our pediatric surgery clinic between July 2019 and December 2022, the records of patients aged 0-18 who underwent laparoscopic appendectomy were retrospectively investigated. The clinical findings, surgical procedure, and results of intervened inguinal hernia cases during laparoscopic appendectomy were evaluated.
Results:
Between the study dates, 293 laparoscopic appendectomies were performed in our clinic. Patent processus vaginalis was observed in 5 (1.7%) cases. Laparoscopic hernia repair was performed with the Burnia technique in 2 girls. In one case, the omentum was herniated and adhered to the hernia sac seen during laparoscopy. In another case, swelling in the groin occurred during the introduction of air into the abdomen at the beginning of the operation. Patent processus vaginalis seen in 3 asymptomatic cases was not intervened. There were no postoperative complications or recurrences in the two patients who underwent hernia repair.
Conclusion:
Hernia repair with the Burnia technique might be safely performed in symptomatic inguinal hernia cases seen during laparoscopic appendectomy for early appendicitis.
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