Laparoscopic surgery of inguinal hernia in children - experience with 110 repairs

Background: Laparoscopic inguinal herniorraphy has been in practice in adults since its initial description by Ger in 1921. However there is no standardized technique for children until now. We present a series 110 repairs of hernias in infants and children treated laparoscopically. The aim of this study is to document authors' experience with laparoscopy in inguinal hernia in girls and boys.
Material and Methods: The procedure was performed with three ports, one telescopic and the other two for needle holders. The internal inguinal ring was closed with or without dissection of sac with stitches of 3-0® Vicryl. A total of 80 children underwent surgery.
Results: Once the technique of intracorporeal suturing technique is mastered, the procedure is straightforward requiring 25 minutes for unilateral and 35 minutes for bilateral hernias. Age of the patient and size of the internal inguinal ring do not influence the outcome because of magnifying effect of laparoscopy. In more than half of our patients, the preoperative diagnosis could not be matched unequivocally with the intraoperative findings. There were three recurrences in the earlier phase of study before mastering the intracorporeal suturing technique. Apart from one case which developed transient hydrocele postoperatively, no other serious complications were noted.
Conclusion: Laparoscopic repair of inguinal hernia in children has proved to be feasible, safe and reliable technique. A contralateral patent processus vaginalis (PPV) is present in a surprising number of young children and laparoscopy offers safe alternative to treat both sides at the same sitting. Cosmesis is superb.

Keywords
Paediatric inguinal hernia in children, Laparoscopic repair of inguinal hernia in children, Laparoscopy.