Laparoscopic hernia repair in children: Which method is the best?

Abstract

This study aimed to evaluate the outcomes of laparoscopic inguinal hernia (LIH) repair in pediatric patients in our clinic. LIH repairs that are between January 2008 and April 2013 were evaluated retrospectively. LIH repair was performed between in 133 patients with a mean age of 5.57 years (range 1 month-17 years). For the repairs, either the Schier’s, Montupet’s, or percutaneous internal ring suturing (PIRS) techniques were used. Of the cases, 67 were on the right side (50.4%), 33 on the left (24.8%), and 33 were bilateral (24.8%). Of the patients who underwent laparoscopic surgery for inguinal hernia (133) 70 were male. Schier’s method was used in 23 patients, 8 with bilateral hernias. Montupet’s was used in 28 patients (4 with bilateral hernias). The PIRS method can be very well considered as the first choice because of it is relatively easy to apply, can be completed in less operative time, and is more cost effective than the other methods. In 7 cases, concomitant umbilical hernias were used as camera ports and repaired at the end of the operation. One femoral hernia was diagnosed and repaired. No complications or recurrences occurred during the mean 48-month (16-76 months) follow up. LIH repair is a safe method in children, it is affordable compared to other laparoscopic operations, and it is advantageous, especially in recurrent hernias, in cases concomitant with umbilical hernias, and in bilateral hernias. The PIRS method may be the first choice because of its lesser operative time, expense, and need for surgical experience.