A Safe Laparoscopic Technique for the Repair of Inguinal Hernias in Boys

Prospective randomized single-center, single-blind Comparison of laparoscopic vs open repair of pediatric inguinal hernia

“…In normal situations, recurrence after an open proecedure may be attributed to a failure to ligate the sac high enough at the internal ring, injury to the floor of the inguinal canal due to operative trauma, failure to close the internal ring in girls, or postoperative wound infection and hematoma [8]. Our laparoscopic technique for the repair of IH has proven to be a safe method, when performed carefully, that can prevent avoid all these possible causes of recurrence [3,4]. No recurrences were found in any of our LR patients after a mean follow-up period of 12 months.…”

“…The laparoscopic technique that we used has been described elsewhere [3,4] For the lateral ports, we used 3-mm instead of 5-mm reusable ports, as described previously, to reduce postoperative pain and improve cosmesis [4]. Briefly, after saline was injected extraperitoneally to separate the testicular vessels and vas deferens from the peritoneum, a purse-string stitch was placed around the internal inguinal ring and a knot was tied intracorporeally to close the patent internal inguinal opening.…”

Herniotomy in Infants, Children and Adolescents without Disruption of External Ring

“…But still recurrent hernia in the pediatric age group is very difficult doing an interior (open) approach and there is a high risk of damaging the vas deferens and testicular vessels during dissection of a previously opened hernia, so laparoscopic repair 17,18 is the preferred operation for recurrent inguinal hernia in children after an open repair. Also a laparoscopic approach can show both deep rings and in one study they found that 26% of boys presented with unilateral inguinal hernia.…”

Pediatric Laparoscopic Surgery: Four Years Experience in Dhaka Medical College Hospital

“…Moreover an advantage of this procedure is that, it allows detection and repair of the contra lateral hernia in same setting. 4,5,6 Laparoscopic suturing and knot tying are becoming integral part of the skill that any laparoscopist must acquire and intracorporial suturing and knot tying for closure of the internal inguinal ring may need a long learning curve. 7 In our study, out of the 36 patients with Inguinal Hernia, 29 patients had unilateral pathology and 7 patients were found to have bilateral pathology on laparoscopy though they presented with unilateral problem.…”