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Updated: Jun 26, 2026
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Mechanisms of recurrence after laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia: a
Wataru Sumida1, Yasuyuki Ono2, Junko Mouri2
1Aichi Children's Health and Medical Center, Department of Pediatric Surgery, 7-426 Morioka cho, Obu, 474-8710, Japan. wsumida288gto@yahoo.co.jp.
Background:
Laparoscopic assisted percutaneous extraperitoneal closure (LPEC) is widely used in Japan for pediatric inguinal hernia repair and associated with a low recurrence rate. This study aimed to investigate recurrent cases to determine possible causes.
Methods:
This study retrospectively reviewed patients who underwent reoperation for ipsilateral recurrence after the initial LPEC performed at our institution between 2009 and 2024. Recurrence was confirmed through 2025. Medical records and operative videos were analyzed to evaluate patient characteristics, interval to recurrence, operative findings, recurrence patterns, and reoperative procedures. Recurrence rates were also compared based on the suture material.
Results:
In 1,894 patients, 11 recurrences (0.58%) occurred. No significant differences in age, sex, or side were observed. The median interval to recurrence was 32 months. The video review identified one technical error involving needle deviation into the muscle layer. Two cases were de novo-type recurrences. In nine cases, a central pinhole in the ligation ring suggested ligature loosening. Recurrence rates were lower with polyester sutures than with silk (0.16% vs. 0.79%), though not statistically significant (p = 0.28).
Conclusions:
LPEC demonstrated a low recurrence rate. Most recurrences were associated with inadequate ligation, and recurrence rates tended to be lower with polyester sutures.
