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Updated: Jan 11, 2026
Application of Straight-needle, Three-tailed, Knot-free, Peritoneal Sutures in Laparoscopic Transabdominal Preperitoneal Hernia Repair
Published on: November 12, 2021
Percutaneous internal ring suturing versus conventional laparoscopic repair of congenital inguinal hernia: a
Israa Saad1, Mostafa Zain2, Ahmed Khairi2
1Alexandria Faculty of Medicine, University of Alexandria, Alexandria, 21615, Egypt. Israasaad1000@gmail.com.
Insights
Percutaneous internal ring suturing (PIRS) offers a faster, safer, and more cosmetically pleasing repair for pediatric congenital inguinal hernias compared to traditional laparoscopic methods. This technique leads to reduced operative times and improved patient outcomes.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Innovation
Background:
- Congenital inguinal hernia (CIH) repair techniques are evolving for minimal invasiveness and efficacy.
- Laparoscopic approaches are common, but comparisons between techniques are ongoing.
- Assessing new methods against established ones is crucial for optimizing pediatric surgical care.
Purpose of the Study:
- To compare percutaneous internal ring suturing (PIRS) with conventional laparoscopic repair for CIH.
- To evaluate feasibility, safety, operative time, cosmetic results, and recurrence rates.
- To determine the superior method for pediatric congenital inguinal hernia repair.
Main Methods:
- A prospective randomized study involving 109 male patients with 120 CIHs.
- Patients were divided into two groups: laparoscopic disconnection/ring narrowing (Group A) and PIRS (Group B).
- Perioperative data, complications, recurrence, and parental satisfaction were assessed.
Main Results:
- PIRS (Group B) had significantly shorter operative times (8.5 min) than laparoscopic repair (Group A) (40.8 min).
- Lower rates of spermatic cord edema were observed in PIRS (1.9%) versus laparoscopic repair (19.6%).
- Recurrence rates were similar (1.9% vs 5.4%), but parental satisfaction with scarring was higher with PIRS.
Conclusions:
- PIRS is a more efficient and cosmetically superior technique for pediatric CIH repair.
- PIRS demonstrates reduced operative time and lower complication rates compared to conventional laparoscopy.
- This study supports PIRS as a favorable alternative for congenital inguinal hernia treatment in children.
Background:
Laparoscopic repair of congenital inguinal hernia (CIH) has evolved with techniques to minimize invasiveness while ensuring efficacy. This study compares percutaneous internal ring suturing (PIRS) with laparoscopic disconnection of the hernial sac and internal ring narrowing regarding feasibility, safety, operative time, cosmetic outcome, and recurrence rate.
Methods:
A prospective randomized study was conducted on 109 male patients with 120 CIHs. Patients were allocated into two groups: Group A (laparoscopic disconnection and internal ring narrowing) and Group B (PIRS). Perioperative parameters, postoperative complications, recurrence rates, and parental satisfaction with cosmetic results were assessed.
Results:
The mean operative time was significantly shorter in group B (8.5 ± 3.9 min for unilateral cases) compared to group A (40.8 ± 9.9 min) (p < 0.001). Postoperative spermatic cord edema occurred in 19.6% of Group A and 1.9% of Group B (p < 0.05). Recurrence rates were 5.4% in Group A and 1.9% in Group B (p > 0.05). Parental satisfaction with scarring was significantly higher in group B (p < 0.05).
Conclusion:
In this randomized trial, PIRS resulted in shorter operative time, lower incidence of spermatic cord edema, and higher parental satisfaction compared with conventional laparoscopic repair in pediatric patients with congenital inguinal hernia.
Level Of Evidence:
II (Prospective randomized study).
