Application of laparoscopy in special-type pediatric inguinal hernias

Abstract

Objective To evaluate the value of transumbilical two-port laparoscopy on special-type pediatric inguinal hernias. Methods Retrospective analyses were conducted for the clinical data of 15 cases with special-type inguinal hernias from January 2012 to January 2015. Results Among 8 cases of sliding inguinal hernia, there were 6 girls(5 left sided, 1 right sided) and 2 boys(bilateral). Ovary and Fallopian tubes constituted a part of hernia sac in all girls while sliding component of hernia sac was ileocecum in boys. None was reducible. Four boys had Amyand's hernia and three of them had a history of fever and a tender irreducible scrotal swelling with red edematous skin. The incarcerated contents of hernia sac were ileocecum with inflamed appendix(n=1) and isolated suppurative appendix(n=3). Laparoscopic hernia sac high ligation was performed. With suspension at right lower quadrant, the appendixes were removed laparoscopically, a thorough wash of sac followed by rubber drainage was then performed. Direct inguinal hernia was found in 2 boys and 1 girl. One had bilateral hernias and another two coexisting indirect inguinal hernia. Trans-umbilicus two-port laparoscopy was performed with additional trocar required under specific circumstances. The average length of hospital stay was 2.8±0.8 days. There was neither incision infection nor scrotal hematoma. During a follow-up period of 6 months to 3 years, neither recurrence nor testicular atrophy occurred. Conclusions Transumbilical two-port laparoscopy is both safe and mini-invasive for special-type inguinal hernias. Key words: Inguinal hernia; Laparoscopy; Surgical procedure, mini-invasive