Comparison of laparoscopic percutaneous internal ring suturing method and open inguinal hernia repair in children under 3 months of age

Abstract

Objective: Laparoscopic inguinal hernia repair in younger infants has not been completely accepted worldwide. The aim of this study was to evaluate the safety and feasiblity of laparoscopic percutaneous internal ring suturing method in children aged younger than 3 months and compare the recurrence and complication rates with open repair; which may still be mentioned as the gold standard procedure. Material and Methods: A total of 387 children underwent inguinal hernia repair in the clinic between 2016 and 2019. One hundred and forty of them were under 3 months old and divided into two groups; children who underwent laparoscopic percutaneous internal ring suturing (Group 1) and open surgery (Group 2). Selection of the surgical method was regardless of weight, sex or any patient characteristics other than surgeon’s choice. Operation durations, complications and recurrences were compared between the two groups. Results: A total of 140 patients underwent surgery due to inguinal hernia. Group 1 included 85 and Group 2 included 55 children. There were two recurrences in each group (p> 0.05). Operative durations were shorter in Group 1 for both; unilateral and bilateral repairs (< 0.0001). There were no intraoperative complications in any group. There was one major postoperative complication in Group 2: iatrogenic undescended testis, and none was observed in Group 1. In the laparoscopic group, 47% of the children who were diagnosed to have unilateral hernia were revealed to have bilateral inguinal hernias (n= 31). Conclusion: Laparoscopic percutaneous internal ring suturing method seems favourable in terms of operative time. It also has the advantage of detecting contralateral patent processus vaginalis or asymptomatic contralateral inguinal hernia.

Percutaneous Internal Ring Suturing for the Minimally Invasive Repair of Congenital Inguinal Hernia in Neonates: A Retrospective Cohort Study

“…When we compare the findings of our current study of neonates with our previous study of children >1 year old [5], our surgical times appear to be higher in neonates (20.3 vs 14.3 for unilateral and 25.8 vs 20.4 for bilateral repair.) On the other hand, in a study of children <3 months of age undergoing PIRS [12], the mean surgical time of 85 children was reported as 24 minutes for unilateral and 33 minutes for bilateral PIRS, similar to our findings. Patkowski et al also reported their experience with PIRS in children <3 months of age, with an average surgical time of 23 minutes for unilateral and 26 minutes for bilateral hernias [11].…”

Single Port Laparoscopic (SPL) Inguinal Hernia Repair in Girls

“…This finding was a bit similar to a study conducted by Kumar and colleagues 9 which showed that incidence of occult hernia was 16.67%. Safety of laparoscopic single port herniotomy with respect to recurrence, wound infection and cosmetics has also been mentioned by Ergun et al 17 . Recurrence rate in our research was 3.57% (1/28) while Zenitani et al 18 reported similar results in their series of 120 patients with regard to safety and efficacy in children and a lower rate of metachronous contralateral inguinal hernia.…”

Transumbilical Single-Site Laparoscopic Intraperitoneal Closure of the Internal Inguinal Ring for Pediatric Inguinal Hernia

“…However, the learning curve of TUSLIC may be long and steep, which requires much simulator training, even for a senior surgeon. Therefore, this may explain why the ORT in patients receiving TUSLIC was much longer than that of patients receiving TAMLEC or PIRS (20,(22)(23)(24).…”