Laparoscopic inguinal hernia repair in children: To cut or not to cut that is the question?

Abstract

To compare the results and complications of two techniques of laparoscopic paediatric hernia repair. All the children who had laparoscopic inguinal hernia repair done at AIIMS Jodhpur during the period of Sept 2016 to Nov 2017 were retrospectively studied. Patients were divided in two groups depending on whether the hernial sac was divided or not divided before taking a purse-string suture. Total 39 patients were included as per inclusion criteria. Mean age of the patient was 35.4 months (range is 2 months to 12 years). We had 7 female patients. Side of the hernia was bilateral in 7 patients, left side =13 and right side=19 making a total of 46 hernias. Hernial sac was divided before suturing in 17 patients while the sac was left intact before suturing in 22 patients. Mean follow up was 6.7 months (range: 1 to 14). Age, gender, side of hernia, complications and hospital stay were comparable. There was a significant difference between the mean operating times in patients who underwent division of hernia sac with patients in whom the sac was not divided before putting purse-string suture (92.5 mts vs 65.7 mts) respectively, p= 0.0101). One patient in the division of sac group had injury to testicular vessel while dividing the sac while one patient developed hydrocele on follow-up in the other group. There was no recurrence in either of the group. Repair done with or without dividing the peritoneal sac gives comparable results with lower operating time without sac division.