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Updated: Jan 12, 2026
Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
Published on: November 12, 2021
Laparoscopic percutaneous extraperitoneal closure compared to open repair for recurrent inguinal hernias in children:
Ko Miyazaki1, Naonori Kawakubo2, Shinichi Noguchi3
1Department of Pediatric Surgery, Ehime Prefectural Central Hospital, Ehime, Japan.
Insights
Laparoscopic percutaneous extraperitoneal closure (LPEC) for pediatric recurrent inguinal hernias had a 10.2% re-recurrence rate. Open repair showed no recurrence, though LPEC offered shorter surgical times.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Laparoscopic percutaneous extraperitoneal closure (LPEC) is standard for pediatric inguinal hernias.
- Studies on LPEC for pediatric recurrent inguinal hernias (PRIHs) are limited due to low recurrence rates.
- This multicenter study compares LPEC with open repair for PRIHs.
Purpose of the Study:
- To compare surgical outcomes of LPEC versus open repair for PRIHs.
- To evaluate re-recurrence rates, surgical duration, and complications.
Main Methods:
- A multicenter retrospective study of patients under 15 years old from 2012-2021.
- Included patients who underwent LPEC or open repair for PRIHs across 13 institutions.
- Primary outcome: re-recurrence rate; Secondary outcomes: surgical time, postoperative complications.
Main Results:
- Analyzed 74 patients: 59 in LPEC group, 15 in open repair group.
- Re-recurrence occurred in 10.2% of the LPEC group versus 0% in the open group (p=0.337).
- LPEC group had significantly shorter surgical times (p<0.001) and one surgical site infection.
Conclusions:
- LPEC for PRIHs demonstrated a 10.2% re-recurrence rate, with no recurrences in the open repair group.
- While LPEC offers shorter operative times, its re-recurrence rate warrants further investigation.
- Larger studies and improved LPEC techniques are needed for PRIHs.
Background:
Laparoscopic percutaneous extraperitoneal closure (LPEC) is a common procedure for pediatric inguinal hernia repair, in which the hernial sac is closed via an extraperitoneal approach by using a special needle. Recurrence of inguinal hernias after repair is rare; therefore, few studies on LPEC for pediatric recurrent inguinal hernias (PRIHs) have been conducted, and all of those have comprised small samples. Consequently, we conducted a multicenter study to describe the surgical outcomes of LPEC for PRIHs (LPEC group) compared with those of open repair (open group).
Methods:
This multicenter retrospective study included patients <15 years old who underwent LPEC or open repair for PRIHs from 2012 to 2021 across 13 institutions. The primary outcome was the re-recurrence rate, and the secondary outcomes were surgical time and postoperative complications.
Results:
Seventy four patients (59 in the LPEC group and 15 in the open group) were analyzed. Six patients (10.2 %) in the LPEC group experienced re-recurrence, whereas no re-recurrence occurred in the open group (p = 0.337). The surgical time was significantly shorter in the LPEC group than that in the open group (p < 0.001). One complication (surgical site infection) occurred in the LPEC group, whereas no postoperative complications occurred in the open group (p > 0.99).
Conclusion:
The re-recurrence rate of PRIHs in the LPEC group was 10.2 % (6/59), whereas no re-recurrence was observed in the open group. Further studies with larger samples and longer follow-up periods are necessary, and improvements in the LPEC method for PRIHs should be considered.
