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Laparoscopic Inguinal Hernia Repair in Pediatric Female Patients Using Cautery and Endoloops: Description of
Hayle Noh1,2, Hanan Alansari1,3, Daniel Briatico1,3
1McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada.
Insights
Laparoscopic inguinal hernia repair using cautery and Endoloops is a safe and effective method for pediatric females. This technique is suitable for various hernia types and requires no specialized equipment.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Laparoscopic inguinal hernia repair in children has multiple described techniques.
- The use of cautery and Endoloops offers a specific approach for this patient population.
Purpose of the Study:
- To describe the experience with laparoscopic inguinal hernia repair using cautery and Endoloops in pediatric female patients.
- To evaluate the safety and efficacy of this technique.
Main Methods:
- Retrospective review of 50 pediatric female patients undergoing laparoscopic inguinal hernia repair.
- Technique involved umbilical laparoscopic access, cauterization of the hernia sac, and placement of two PDS Endoloops.
- Outcomes assessed included operative time and complications.
Main Results:
- Median operative time was 30 minutes for unilateral and 33 minutes for bilateral hernias.
- No patients experienced conversion to open procedure, surgical site infection, or recurrence.
- The technique was used for primary, incarcerated, recurrent hernias, and incidental patent processus vaginalis.
Conclusions:
- Laparoscopic inguinal hernia repair with cautery and Endoloops is safe and effective in pediatric females.
- The technique is versatile, applicable to various hernia types.
- No specialized skills, training, or equipment are necessary for this approach.
Purpose:
Multiple techniques have been described for laparoscopic inguinal hernia repair in children. The purpose of this study was to describe our experience using cautery and Endoloops in pediatric female patients.
Methods:
We conducted a retrospective review of pediatric female patients who underwent laparoscopic inguinal hernia repair using cautery and Endoloops at our center. This technique involves establishing laparoscopic access through the umbilicus, everting and cauterizing the hernia sac with a Maryland dissector, and placing two PDS Endoloops at the level of the internal ring. Outcomes included operative time and complications.
Results:
We identified 50 female patients (mean age 5.6 years, range 2 months to 17 years) who underwent laparoscopic inguinal hernia repair using cautery and Endoloops from January 2015 to March 2024. The indication for surgery in most patients was a clinical hernia (n = 43/50). One of these was incarcerated and another was a recurrent hernia. Seven other patients underwent ligation of an incidental patent processus vaginalis during laparoscopic appendectomy (n = 4), laparoscopic ovarian detorsion (n = 2), or diagnostic laparoscopy for possible Meckel's diverticulum (n = 1). Median operative time was 30 minutes for unilateral inguinal hernias (n = 26/43) and 33 minutes for bilateral (n = 17/43). None experienced conversion to open procedure, surgical site infection, or recurrence.
Conclusion:
We conclude that laparoscopic inguinal hernia repair using cautery and Endoloops is safe and effective in pediatric female patients. This technique does not require specialized skills, training, or equipment. We have used this approach for primary repair of clinical hernia, incarcerated hernia, recurrent hernia, and incidental patent processus vaginalis.