Fifteen years experience in laparoscopic inguinal hernia repair in pediatric patients. Results and considerations on a debated procedure

Montupet, Philippe; Esposito, Ciro

doi:10.1007/s00464-010-1188-6

Cited by 66 publications

(46 citation statements)

References 21 publications

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“…[4,9] For more than two decades, several authors have used the laparoscopic pathway for the treatment of PVCP with good results. [4,[19][20][21] In our series, 12 patients (including 4 cases of hernia) less than 2-year-old had been operated when they could legitimately be monitored to determine whether the PVCP was regressive.…”

Section: Discussionmentioning

confidence: 99%

Peritonea-vaginal canal pathologies at Regional Hospital Center of Lomé-Commune (Togo): Epidemiological, anatomoclinical and therapeutic aspects

Simlawo¹,

Tchangaï

Kanassoua

et al. 2017

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Objective: To describe epidemiological, anatomo-clinical and therapeutic aspects of peritoneo-vaginal canal pathologies (PVCP). Methods: We performed a retrospective and descriptive study on the files of PVCP cases operated in Lomé-Commune Regional Hospital (Togo). The study data concerned: the age, the occuring mode, anatomo-clinical classification, the side and treatment outcomes. Results: 107 files were collected from January 2011 to December 2015. The average age was 9.2 ± 8 years with a range from 16 months to 47 years. Twelve patients were less than 2 years and 14 patients were adults. The main consultation motive was an intermittent and painless inguinal or inguino-scrotal swelling in 89 cases (83.18%). The PVCP was in the right side in 66 patients (61.68%) and bilateral in 8 patients (7.47%). Concerning anatomo-clinical types, inguinal or inguino-scrotal hernia were more frequent (62.6%). The treatment was surgical in all cases and the average hospital stay was 2.1 days. The operative follow-up was satisfactory in 94.3%. However, we noticed 4 cases of scrotal hematoma and 2 cases of parietal suppuration. The mortality rate after surgery was zero. One year back, we noticed two cases of testicular atrophy. Conclusions: Pathologies of the peritoneo-vaginal canal are frequent in our surgical practice. Inguinal hernia and inguino-scrotal hernia are more represented. The surgical treatment results are successful.

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Section: Discussionmentioning

confidence: 99%

Peritonea-vaginal canal pathologies at Regional Hospital Center of Lomé-Commune (Togo): Epidemiological, anatomoclinical and therapeutic aspects

Simlawo¹,

Tchangaï

Kanassoua

et al. 2017

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“…However, this treatment is still controversial because of the four main aspects: (1) the exploration of the asymptomatic contralateral side, (2) the incidence of complications related to the possible damage of the vas deferens or the spermatic vessels, (3) the complications related to the surgical technique, such as recurrences of hernia or iatrogenic cryptorchidism and (4) the possibility to identify, using inguinal exploration, rare hernias such as direct or femoral [3,8,10]. Several papers report that routine bilateral exploration would disclose a contralateral sac in about 20 to 90% of cases (>89% in the first year of life), but contend that only a small percentage of these sacs (8 to 20%) would evolve into clinical hernias [3,6].…”

Section: Discussionmentioning

confidence: 99%

“…Analyzing the international literature, there are mainly two procedures to adopt: unilateral inguinal repair and laparoscopic repair [9,10]. There is no evidence in the international literature about the better procedure to adopt [3,11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Although there are numerous articles regarding the data about the incidence of a contralateral patency of the peritoneal-vaginal duct, allowing surgeons to decide whether the inspection or the evaluation of the contralateral region is indicated, the perspective of the child's parents regarding these decisions is rarely reported [5,10]. In our unit, both inguinal and laparoscopic repair are performed, we decided to set up a prospective study to evaluate parents' views on the question regarding their preferred technique to adopt in a child with a known unilateral inguinal hernia.…”

Section: Introductionmentioning

confidence: 99%

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Unilateral inguinal hernia: laparoscopic or inguinal approach. Decision making strategy: a prospective study

Esposito¹,

Giurin²,

Alicchio³

et al. 2012

Eur J Pediatr

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The management of the contralateral region in a child with a known unilateral inguinal hernia is a debated issue among paediatric surgeons. The available literature indicates that the perspective of the child's parents is seldom. This study was performed to evaluate parents' views on this topic. After the Ethical Committee's approval, 100 consecutive patients under 12 years of age with a unilateral inguinal hernia were studied prospectively from March 2010 to September 2010. After an oral interview, a study form was given to the parents about the nature of an inguinal hernia, the incidence of 20 to 90% of a contralateral patency of the peritoneal-vaginal duct and the possible surgical options (inguinal repair or laparoscopic repair). The parents' decision and surgical results were analyzed. Eighty-nine parents chose laparoscopic approach, and 11 parents preferred inguinal exploration. Regarding their motives, all 89 parents requesting laparoscopic approach indicated that the convenience and risk to have a second anaesthesia was the primary reason of their decision. The 11 parents who preferred inguinal approach indicated that the fear of a new surgical technology was their primary reason. Conclusion There is no consensus about the management of paediatric patients with a unilateral inguinal hernia. We believe that a correct decision-making strategy for parents' choice is to propose them the both procedures. Our study shows that parents prefer laparoscopic inspection and repair in the vast majority of cases.

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“…Laparoscopic approaches offer the superior visualization to potentially avoid trauma to the vas deferens and spermatic vessels and the opportunity to accomplish a safe high ligation of the hernia sac at the internal ring [23,[31][32][33].…”

Section: Surgical Proceduresmentioning

confidence: 99%

Individualized Treatment of Inguinal Hernia in Children

Chen¹,

Chu²,

Shen³

et al. 2017

Hernia

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The incidence of inguinal hernias in various age groups of children ranges from 0.8 to 4.4%. Pediatric indirect inguinal hernia is congenital, originating in the patent processus vaginalis. The inguinal hernia repair is one of the most common pediatric operations. The traditional high hernia sac ligation is the primary treatment for younger patients from 1 to 13 years of age and can correct the condition. The authors performed the high ligation of the hernia sac by the laparoscopic approach for the patients under 13 years old and achieved good therapeutic results in the last 10 years. However, through our clinical study, the authors found that the simple high ligation of hernia sac is inadequate for patients from 13 to 18 years of age, who had a longer medical history, larger diameter of the internal inguinal ring, and more serious defects of the transverse fascia. Pediatric inguinal hernias are prone to postoperative recurrence if the patients were only treated with the high ligation of hernia sac. To repair the transverse fascia and strengthen the posterior wall of the inguinal canal, Lichtenstein hernioplasty with a biological patch was performed for the patients from 13 to 18 years in the authors' department. The aims of this chapter are to narrate the individualized treatment of inguinal hernia in children and try to provide relatively reasonable operative methods.

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Fifteen years experience in laparoscopic inguinal hernia repair in pediatric patients. Results and considerations on a debated procedure

Cited by 66 publications

References 21 publications

Peritonea-vaginal canal pathologies at Regional Hospital Center of Lomé-Commune (Togo): Epidemiological, anatomoclinical and therapeutic aspects

Peritonea-vaginal canal pathologies at Regional Hospital Center of Lomé-Commune (Togo): Epidemiological, anatomoclinical and therapeutic aspects

Unilateral inguinal hernia: laparoscopic or inguinal approach. Decision making strategy: a prospective study

Individualized Treatment of Inguinal Hernia in Children

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