Do open repair and different laparoscopic techniques in pediatric inguinal hernia repairs affect the vascularization of testes?

Abstract

Purpose: The aim of this study was to evaluate, using Doppler ultrasonography, the effects of different hernia repair techniques on testicular perfusion in the pediatric age group.

Methods: This study was based on a prospective clinical trial of 72 pediatric patients over 2 years of age with unilateral inguinal hernia. They were operated on using 1 of 3 different techniques. Group 1 included 26 patients who were treated with a conventional open hernia repair technique. Group 2 included 22 patients who underwent Schier intracorporeal laparoscopic suture technique. Group 3 included 24 patients who underwent the laparoscopic partial excision and purse-string technique described by Montupet. In all cases, blood flow index of the centripetal and capsular arteries of the testes, including peak systolic velocity (PSV) and resistivity index (RI), were examined by using Doppler ultrasound preoperatively and early and late postoperatively.

Result: The conventional open technique group (group 1) had transient temporary changes in PSV and RI values compared with preoperative findings; however, these changes were not statistically significant. No such changes were observed in the 2 laparoscopic groups.

Conclusion: Neither conventional open nor laparoscopic hernia repair techniques impaired testes vascularization. Surgical manipulations performed using the conventional open repair technique caused transient, but not significant, changes in PSV and RI values.