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Laparoscopic treatment of recurrent inguinal hernia in children
1Cattedra di Chirurgia Pediatrica, Università degli Studi di Napoli "Federico II", Via Pansini 5, I-80131 Napoli, Italy.
Insights
Laparoscopic surgery offers a safe and effective treatment for recurrent inguinal hernias in children. This minimally invasive approach demonstrated successful outcomes with no complications in early studies.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Recurrent inguinal hernias in children pose a surgical challenge.
- Conventional treatments may have limitations for recurrent cases.
Purpose of the Study:
- To evaluate the feasibility and safety of laparoscopic treatment for recurrent inguinal hernias in pediatric patients.
- To report the surgical technique and outcomes.
Main Methods:
- A laparoscopic technique using three trocars was employed.
- Specific suturing methods were used to close the peritoneal vaginal duct or direct inguinal hernia defects.
- The study included 225 boys aged 8 months to 14 years, with 10 cases of recurrent inguinal hernias.
Main Results:
- Ten boys with recurrent inguinal hernias underwent successful laparoscopic repair.
- No intra- or post-surgical complications were reported.
- All patients achieved total recovery from hernia at a maximum follow-up of 3 years.
Conclusions:
- Laparoscopic surgery is a feasible and safe option for treating recurrent inguinal hernias in children.
- The described laparoscopic technique shows promising early results for pediatric recurrent inguinal hernia repair.
Abstract:
The authors report their experience with the laparoscopic treatment of recurrent inguinal hernia in children. Between April 1993 and January 1998, 225 boys aged 8 months to 14 years (mean 4.4 years) were treated laparoscopically for a hydrocele, spermatic-cord cyst, or hernia. Ten boys had recurrent inguinal hernias after conventional surgery, in one case bilateral. The technique requires 3 trocars: a 0 degrees, 5-mm telescope inserted through the umbilicus and two 3-mm trocars placed 3-4 cm below the umbilicus on either side. Simple patency of the peritoneal vaginal duct (dpv) was found in eight cases and a direct inguinal hernia in three. In cases with an open dpv, we opened the external hemicircumference of the neck in order to bring the conjoined tendon closer to the crural arch with a non-resorbable 4/0 suture, and then placed a 3/0 resorbable pursestring suture around the peritoneum of the internal orifice of the inguinal canal. In direct inguinal hernias the orifice was closed by placing 2-3 nonabsorbable 3/0 sutures between the two muscular sides of the hernial defect. There were no intra- or postsurgical complications. All patients, at a maximum follow-up of 3 years showed total recovery from the hernia. Our early results suggest that laparoscopic surgery is a feasible and safe technique for the treatment of recurrent inguinal hernia in children. Key words Recurrent inguinal hernia. Laparoscopy. Children