Characteristics of laparoscopic inguinal hernia recurrences

Abstract

Boys had more recurrences than girls. Most recurrences occur medially. The more experienced the surgeon was, the fewer recurrences he had. The stitches at the medial aspect of the hernia, close to the vas, seem to be the most crucial ones.

Laparoscopic inguinal herniorrhaphy in babies weighing 5 kg or less

“…The results of the traditional open herniotomy, at least for children of low body weight, are characterized by significantly high rates for recurrence, testicular hypotrophy, and atrophy or high testis that requires subsequent orchiopexy. Although the recurrence rate for laparoscopic inguinal hernia cases seems to remain elevated for older children [2,5,[10][11][12][13][14], our results for babies weighing 5 kg or less suggest a lower recurrence rate than that reported by Nagraj et al [1] for open herniotomy (2.0% vs 2.7%) in a comparable group of patients.…”

“…The benefit of the laparoscopic approach for hernia recurrence in children after initial repair, whether from previous open surgery or a laparoscopic approach, has been well described by Schier et al [13,14]. Age, size, and weight of the child are not limiting factors for the laparoscopic approach in terms of surgical technique.…”

Laparoscopic needle-assisted inguinal hernia repair in 495 children

“…In one of the largest studies involving 712 hernia repairs in 542 children performed using 3 trocars, an ''N-shaped closure,'' and intracorporeal knot tying, and a 3.7 % recurrence rate was seen [6]. In a follow-up series including 1,071 hernia repairs, recurrences decreased to 1.9 % in the most experienced surgeon [7]. Other recent studies utilizing an intracorporeal pursestring with sectioning of the distal sac [8] and extra-corporeal knot tying have documented recurrence rates \1.5 %, similar to patients following open repair.…”

“…In a series that reviewed open hernia repairs, the average time to recurrence was between 1 and 2 years [1,19]. In contrast, recurrences seem to occur earlier in laparoscopic series, often within the first 6 months [7]. Cosmesis is a crucial factor when discussing laparoscopic methods.…”

Laparoscopic hernioraphy: a better approach for recurrent hernia in boys?

“…Femoral hernias are often misdiagnosed and treated as inguinal hernia in open surgery. The diagnostic accuracy of the femoral hernia is only 35 % [14][15][16][17][18][19]. In our series, this problem was demonstrated by a patient who had undergone two operations for an indirect inguinal hernia.…”