Laparoscopic Multiport Inguinal Hernia Repair in a Male Infant

Abstract

Inguinal hernias in infants and children may be treated with open surgery or laparoscopy. First performed in 1993 more and more pediatric surgeons in western countries use the laparoscopic technique, at least in older children. Laparoscopic repair may be performed by either intra- or extra corporeal closure of the open processus vaginalis. The intra-corporeal method uses an intracorporeal suture with the help of three ports while the extra-corporeal closure uses a suture that is passed over two needles and the knot is tied manually outside the patient without the need for an additional port. We hereby describe step by step the laparoscopic multiport inguinal hernia repair in a male infant. This includes positioning of patient and trocars, incision of the peritoneum and placement of a non-absorbable braided purse-string suture at the inner inguinal ring, and intracorporal knot tying using the laparoscopic sliding knot. Minimally invasive hernia surgery in children is a common and technically demanding operation that lends itself well to teaching residents.