Abstract
Background. Laparoscopic hernia repair in infancy and childhood is still debatable. The objective of this study is to compare laparoscopic assisted hernia repair versus open herniotomy as regards operative time, hospital stay, postoperative hydrocele formation, recurrence rate, iatrogenic ascent of the testis, testicular atrophy, and cosmetic results. Patients and Methods. Two hundred and fifty patients with inguinal hernia were randomized into two equal groups. Group A was subjected to laparoscopic inguinal hernia repair. Group B was subjected to open herniotomy. The demographic data were matched between both groups. Assessment of the testicular volume and duplex assessment in preoperative, early, and late postoperative periods were done. Results. All cases were completed successfully without conversion. The mean operative time for group A was 7.6 ± 3.5 minutes, 9.2 ± 4.6 minutes and 11.4 ± 2.7 minutes, for unilateral hernia, unilateral hernia in obese child, and bilateral hernia, respectively. The recurrence rate was 0.8% in group A, whereas in group B the recurrence rate was 2.4%. Conclusion. Laparoscopic hernia repair by RN is an effective line of hernia repair. It resulted in marked reduction of operative time, low rate of recurrence, no testicular atrophy, no iatrogenic ascent of the testis, and excellent cosmetic results.
Highlights
Inguinal hernia (IH) repair is one of the most frequently performed surgical procedures in infants and children
This paper presents a big series and describes a new technique which is the use of Reverdin Needle (RN) in laparoscopic hernia repair in comparison with open herniotomy (OH), to the best of our knowledge, this technique has not been reported before
No intraoperative complications occurred during this study
Summary
Inguinal hernia (IH) repair is one of the most frequently performed surgical procedures in infants and children. Many centers routinely perform laparoscopic hernia repair in children and there have been numerous reports describing various laparoscopic techniques rather than the traditional open approach [1,2,3,4]. Reported advantages of laparoscopic hernia repair include excellent visual exposure, minimal dissection, less complications, comparable recurrence rates, and improved cosmetic results compared with the traditional open approach. The objective of this study is to compare laparoscopic assisted hernia repair versus open herniotomy as regards operative time, hospital stay, postoperative hydrocele formation, recurrence rate, iatrogenic ascent of the testis, testicular atrophy, and cosmetic results. Group A was subjected to laparoscopic inguinal hernia repair. Laparoscopic hernia repair by RN is an effective line of hernia repair It resulted in marked reduction of operative time, low rate of recurrence, no testicular atrophy, no iatrogenic ascent of the testis, and excellent cosmetic results
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