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Comparing Postoperative Outcomes Between Laparoscopic-Assisted Percutaneous Internal Ring Suturing and Laparoscopic
Zakaria W Shkoukani1,2, Tara Ghazi2, Jude Foudeh2
1Department of Urology, Mersey and West Lancashire Teaching Hospitals NHS Trust, Prescot, GBR.
Insights
Laparoscopic intracorporeal internal ring suturing (LICS) and laparoscopic-assisted percutaneous internal ring suturing (LAPIRS) are safe and effective for pediatric inguinal hernia repair. Both methods show comparable outcomes with minimal complications and no recurrences.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Congenital inguinal hernias are common pediatric surgical conditions.
- Laparoscopic repair offers advantages over open repair, but internal ring closure methods are debated.
- This study compares laparoscopic intracorporeal internal ring suturing (LICS) and laparoscopic-assisted percutaneous internal ring suturing (LAPIRS) in children.
Purpose of the Study:
- To compare the outcomes of LICS and LAPIRS for laparoscopic inguinal hernia repair in pediatric patients.
- To evaluate safety, efficacy, complications, and costs associated with each technique.
Main Methods:
- Retrospective cohort study of 38 pediatric patients undergoing laparoscopic inguinal hernia repair.
- Data collected included demographics, operative details, complications, costs, and follow-up outcomes.
- Patients undergoing concurrent orchidopexy were excluded.
Main Results:
- No intraoperative complications were observed in either LICS or LAPIRS groups.
- Mean operative time was 45 minutes, with no significant difference between techniques.
- Postoperative morbidity was minimal, with no recurrences or wound infections at six months follow-up. Costs were comparable.
Conclusions:
- Both LICS and LAPIRS are safe, effective, and cosmetically favorable for pediatric inguinal hernia repair.
- Outcomes were comparable between the two techniques, with negligible morbidity and no recurrences.
- Larger prospective studies are needed to further refine best-practice recommendations.
Background:
Congenital inguinal herniae are among the most common conditions requiring surgery in children. While laparoscopic repair offers diagnostic and cosmetic advantages over open repair, debate persists regarding the optimal method of internal ring closure. This study compares outcomes of laparoscopic intracorporeal internal ring suturing (LICS) and laparoscopic-assisted percutaneous internal ring suturing (LAPIRS) in a paediatric population.
Methods:
We conducted a retrospective cohort study of children who underwent laparoscopic inguinal hernia repair at Jordan University Hospital between January 2019 and December 2020. Demographic data, clinical presentation, operative details, complications, costs, and follow-up outcomes were analysed. Patients undergoing concurrent orchidopexy were excluded.
Results:
Of the 221 patients treated for inguinal herniae, 38 met the inclusion criteria (27 males, 11 females; mean age 3 years, range 45 days to 13 years). Seventeen patients (44.7%) underwent LAPIRS and 21 patients (55.3%) underwent LICS. No intraoperative complications occurred. Mean operative time was 45 minutes, with no significant difference between techniques or laterality (p = 0.849). Postoperative morbidity was minimal, with only one case of umbilical disfigurement following LAPIRS. No recurrences or wound infections were observed after a minimum of six months' follow-up. The median cost was 512 Jordanian Dinars (JOD), equivalent to $720 US dollars, and was unaffected by technique (p = 0.395).
Conclusions:
Both LICS and LAPIRS are safe, effective, and cosmetically favourable options for paediatric inguinal hernia repair. Outcomes were comparable, with negligible morbidity and no recurrences. Given potential differences in learning curve, cosmesis, and cost reported internationally, larger prospective studies with longer follow-up are warranted to refine best-practice recommendations.
