Abstract
Background
Laparoscopic inguinal hernia repair is rarely reported in pediatric patients. We report our 15-year experience on this topic to show the long-term results of this technique.
Methods
During a 15-year period, we operated 596 boys for unilateral inguinal hernia using laparoscopy. The age range was variable from 6 months to 15 years (median, 54 months), with a median body weight of 18.5 (range, 8–54) kg. Preoperatively, 352 boys had a right hernia and 172 had a left hernia. We always used three trocars. We used the laparoscopic herniorrhaphy described by our group 15 years ago; it consists of sectioning the sac distally to the inguinal ring and performing a pursestring suture around the periorificial peritoneum using a 4/0 nonresorbable suture.
Results
The median operating time was 19 min. All procedures were performed in a day-hospital setting. As for laparoscopic findings in 95 of 596 patients (15.9%), we found a contralateral patency of the processus vaginalis. In these 95 cases, we performed bilateral herniorrhaphy. In 7 of 596 patients (1.2%), we discovered a direct hernia. With follow-up between 1 and 15 years, we have only 11 recurrences (1.5%)—all reoperated by laparoscopy.
Conclusions
We believe that laparoscopic repair of inguinal hernia performed by expert hands is a safe and effective procedure to perform with long-term follow-up. Its ability to repair simultaneously all forms of inguinal hernias together with contralateral patencies has cemented its role as a viable alternative to conventional repair.
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Dr. Philippe Montupet and Dr. Ciro Esposito have no conflicts of interest or financial ties to disclose.
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Montupet, P., Esposito, C. Fifteen years experience in laparoscopic inguinal hernia repair in pediatric patients. Results and considerations on a debated procedure. Surg Endosc 25, 450–453 (2011). https://doi.org/10.1007/s00464-010-1188-6
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DOI: https://doi.org/10.1007/s00464-010-1188-6