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. 2005 Oct-Dec;9(4):393-8.

Laparoscopic inguinal hernia repair in children

Palanivelu Chinnaswamy  1 , Vijaykumar Malladi, Kalpesh V Jani, R Parthasarthi, Roshan A Shetty, Alfie Jose Kavalakat, Anand Prakash
Affiliations

Laparoscopic inguinal hernia repair in children

Palanivelu Chinnaswamy et al. JSLS. 2005 Oct-Dec.

Abstract

Background: This study aimed to document the authors' experience with laparoscopic inguinal hernia repair in children.

Methods: Ninety-three hernia repairs were performed in 64 children. The neck was closed with a purse string suture by using 4-0 absorbable suture.

Results: Ninety-three indirect inguinal hernial sacs were closed in 64 children. Nine percent of children had an ectopic testis. The mean operating time for laparoscopic ring closure was 25 minutes (range, unilateral 21 to 35; bilateral, 28 to 50). The contralateral processus vaginalis was patent in 20% of children. In 24% of children, the final procedure was modified based on the findings of a dilated internal ring. A laparoscopic ilio-pubic tract repair was done in these cases. Laparoscopic mobilization, orchiopexy followed by ilio-pubic tract repair was done in 9% of children. Scrotal swelling occurred in one child. Hydrocoele occurred in one patient. Recurrence rate was 3.1%.

Conclusion: Laparoscopic inguinal hernia repair in children can be offered, as it is safe, reproducible, and technically easy for experienced laparoscopic surgeons. Ilio-pubic tract repair may be added in cases with dilated internal ring. Recurrence following laparoscopic ring closure can be managed with laparoscopic ilio-pubic tract repair. The long-term follow-up of laparoscopic ilio-pubic tract repair is awaited.

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Figures

Figure 1.
Figure 1.
Laparoscopic ring closure: suture starting on the medial aspect of the internal ring.
Figure 2.
Figure 2.
Laparoscopic ring closure: continuation of the purse string on the inferior aspect of the internal ring.
Figure 3.
Figure 3.
Laparoscopic ring closure: completion of the purse string suture and occlusion of the internal ring.
Figure 4.
Figure 4.
Dilated internal ring.
Figure 5.
Figure 5.
Laparoscopic iliopubic tract repair: division of the dissected sac. Figure 7. Laparoscopic iliopubic tract repair: approximation of the transversalis fascial arch and iliopubic tract.
Figure 6.
Figure 6.
Laparoscopic iliopubic tract repair: completion of the dissection and landmarks identified: (A) dilated internal ring, (B) iliopubic tract, (C) cord structures, (D) transversalis fascial arch.
Figure 7.
Figure 7.
Laparoscopic iliopubic tract repair: approximation of the transversalis fascial arch and iliopubic tract.
Figure 8.
Figure 8.
Laparoscopic iliopubic tract repair: completion of the iliopubic tract repair.
Figure 9.
Figure 9.
Laparoscopic iliopubic tract repair: after peritoneal flap closure.
See this image and copyright information in PMC

References

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