Laparoscopic repair of congenital inguinal hernia: a comparative study between purse–string suture and peritoneal disconnection with ligation techniques in bilateral cases

Abstract

Many laparoscopic surgical techniques were described for management of inguinal hernia in pediatric patients. This prospective study was conducted to compare laparoscopic purse–string suture of hernia sac at the internal ring at one side, leaving the distal sac intact (technique I) and disconnection of the hernia sac with intra-corporeal suture of proximal part at the internal ring (technique II) in the other side in the same case. Thirty three patients with bilateral congenital inguinal hernia (66 repairs) were included in this study. The outcome variables were operative time, intraoperative complications, post-operative complications and recurrence rate. This study included 28 males and 5 females. The age of the patients ranged from 1 to 72 month with a mean of (15.27 ± 19.09). The operative time was shorter in technique I than in technique II and this difference was statistically significant. No intraoperative complications were reported. Five cases (15%) developed hydrocele and two cases (6%) developed recurrence in technique I during the follow up period. Laparoscopic repair of congenital inguinal hernia using laparoscopic disconnection of the sac and closure of the internal ring has lower recurrence rate and hydrocele formation but longer operative time compared to laparoscopic purse–string closure alone. Due to the high rate of recurrence in technique I, there is definite superiority of technique II as a surgical option.