Evaluation of Laparoscopic Management of Incarcerated Congenital Inguinal Hernia

Abstract

Background: The laparoscopic management of incarcerated congenital inguinal Hernia in children is challenging and may be not devoid of risk. Controversies are still present about its management. Some surgeons prefer immediate repair as emergency even for successfully reduced hernias, others delay the repair for some days. Aim of Study:The aim of this work is to evaluate the safety and efficacy of emergency laparoscopic management of incarcerated congenital inguinal hernia in children.Methods: Eleven patients underwent emergency laparoscopic repair of incarcerated inguinal hernia using burse string sutures around internal inguinal ring.Results: From August 2017 to January 2019, 11 patients were operated (9 males and 2 females) with a mean age of 8.81 ± 4.26 month. 8 right-sided and 3 left-sided hernias. Two patients with contralateral PPV were diagnosed and operated. All hernias were successfully reduced. The hernia content was: Bowel loops 8 (73%), adnexa/ovary 2 (18%), and appendix 1 (9%). The mean operative time was 37.73 ±6.17 minutes. There were no serious complications except that one patient had port site infection and another patient had ipsilateral hydrocele. No recurrence occurred during the follow-up period.Conclusion: Emergency laparoscopic repair of congenital inguinal hernia provide an alternative procedure in pediatric patients presenting with incarcerated hernia. It appears to be feasible, safe and effective with few complications.