A new simplified technique for needlescopic inguinal herniorrhaphy in children

Abstract

Background Needlescopic techniques have been used recently in repairing inguinal hernias (IHs), which made this type of surgery more feasible and less invasive. The technique is being developed further. Objective The objective of this study was to describe and assess the results that can be achieved by using a new simplified technique (Reverdin needle) in needlescopic inguinal herniorrhaphy in children. Patients and Methods All patients with symptomatic IH confirmed by clinical examination were subjected to elective needlescopic herniorrhaphy. One hundred fifty patients with 186 groin hernias, from 2 hospitals in Egypt and Saudi Arabia, in the period from October 1999 to May 2002, were assigned to needlescopic inguinal herniorrhaphy using Reverdin needle. Reverdin needle was used to insert a purse-string suture around the internal inguinal ring to be tied extracorporeally. Results A total of 186 inguinal hernial defects in 150 children were repaired successfully. There were 130 males and 20 females with a mean age of 20.58 ± 21 months (range, 8-96 months). Right-sided IH was present in 86 patients (57.33%); among these patients, an opened internal inguinal ring was found and repaired in 12 cases (8%). Left-sided IH was present in 30 (20%), bilateral hernia in 19 cases (12.67%), and recurrent IH in 20 cases (10%). The mean duration of surgery was 8.7 ± 1.18 minutes for unilateral and 12.35 ± 2 minutes for bilateral hernia repair. There were no intraoperative or postoperative complications. The mean hospital stay was 6 ± 1.21 hours. Conclusion The new technique had all the advantages of needlescopic herniorrhaphy in children (less invasive, less pain, short hospital stay) combined with the advantages of reduced operating time, simplicity, and feasibility. It may be preferable to the intracorporeal suturing and knot tying. However, it needs long-term follow-up.