Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions

Assessment and Management of Inguinal Hernia in Infants

“…60,61 However, data regarding the risk of testicular atrophy are not available. 62,63 A prospective, randomized, single-blinded trial comparing laparoscopic to open repair of inguinal hernias showed that children who were older than 3 months of age when laparoscopic repair was performed required significantly fewer doses of pain medication. 64 The utility of laparoscopic repair of inguinal hernias in younger infants remains undetermined to date.…”

Efficacy of Transumbilical single incision-Laparoscopic-assisted surgery in pediatric patients

“…In 2015, Yuri, et al reported reviewing single incision surgery in a pediatric patient and proposed the nomenclature 'single incision pediatric endosurgery' (SIPES). In the literature, they reported SIPES applied to neonates and patients under 12 months of age [2,[7][8][9]. Numerous studies have address the feasibility of single incisions.…”

Laparoscopic Approach as an Alternative Option in Treatment of Pediatric Inguinal Hernia

“…It is a reciprocal approach where the base of the hernia sac is ligated at the level of the internal inguinal ring, but mostly differs from the original open technique in leaving the sac in place. Albeit the described laparoscopic techniques, there is no single laparoscopic approach that has replaced the traditional repair (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57) . The repair can be classified into two broad categories (intra or extraperitoneal) based on their approaches to the internal ring.…”

“…The repair can be classified into two broad categories (intra or extraperitoneal) based on their approaches to the internal ring. The latter is mainly a subcutaneous endoscopically assisted ligation (40,41,(53)(54)(55)57) . All mentioned approaches require different types of suture material (absorbable nonabsorbable) as well as techniques of knotting (intracorporeal, extracorporeal) and wide range of endoscopic instruments (mainly required during extraperitoneal approach) are available (36,41,54,58) .…”

“…Most of the recurrences are noted within 6 months following the procedure and the most common site of recurrence is along the medial internal ring at the site of passage of the cord structures (51,62,66) . The reported recurrence rates in extracorporeal suturing techniques are given between 0.35-2.8% in which small spaces are left when crossing over the spermatic cord or the testicular vessels (41,54,55,57,62) . On the contrary, the reported recurrence rates 3.1-4.4% are much higher, in which the suture material is tied off in a similar way but intracorporeally (47,52,67) .…”