Laparoscopic inguinal hernia repair in the paediatric age group - experience with 43 children

Md. Ashrarur Rahman1, Diponkar Saha2, Md. Rashedul Islam3
Abstract
Background: Inguinal hernias are among one of the commonest congenital disorders
in paediatric age group. Surgical correction remains the only means to reduce
morbidity. Repair by open inguinal approach has been the treatment of choice for
decades. But with the advent of laparoscopy, closure of the defect by laparoscopic
approach has gained much popularity among paediatric surgeons recently.Although
paediatric laparoscopy is a new introduction in the armory of paediatric surgery in
Bangladesh, it’s use has being increasingly practiced by paediatric laparoscopic
surgeons in this country to correct inguinal hernias in children.
Aims & objectives: This study was conducted to assess the efficacy of paediatric
laparoscopy in the management of inguinal hernias in children with minimal surgery
related tissue trauma.
Material and methods: A review was performed of the prospectively collected data
of 57 laparoscopic internal ring closures in 43 children (age, 30 days-11 years); from
June 2007 to May 2010. The internal ring was closed with a 3/0 non-absorbable silk
suture and intracorporeal method of knotting was used. All patients were asked to
return at1 week and 6 weeks postoperatively for routine follow-up.
Results: A contralateral patent processus vaginalis (PPV) was present in 13% (7/43)
of boys and 2 %( 2/43) of girls. There were 2 recurrences (4.6%). Mean operating time
was 32 minutes for unilateral and 43 minutes for bilateral inguinal hernia. There
was no testicular atrophy observed during follow-up.
Conclusion: Laparoscopic inguinal hernia repair is technically easier, as there is
no need to dissect the vas-deferens and vessels, and the cosmetic result is better.
Although recurrences were more common early in the series, currently they are
much less frequent. Laparoscopic inguinal hernia repair appears to have less
morbidity than open herniotomy and can be used as routine procedure in the
paediatric age group.

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