Laparoscopic repair of pediatric inguinal hernia—is vascularity of the testis at risk? A study of 125 testes

Abstract

Aim The aim of this study was to study the effects of laparoscopic inguinal hernia repair on testicular perfusion and size. Materials and Methods A prospective study concerning laparoscopic inguinal hernia repair was performed for an 18-month period to evaluate testicular perfusion and size in the preoperative, early postoperative (within 48 hours of surgery), and late postoperative periods (6 months after surgery) using Doppler ultrasound (DUS) (both duplex and power Doppler mode). Laparoscopic closure of the deep inguinal ring was accomplished with a purse string suture (Nylon 3-0) using standard 3-port technique. The testis units were divided in 2 groups: group 1 comprising testis units in which a resistive index (RI) could be calculated and group 2 with instances in which an RI could not be calculated but showed blood flow consistently on DUS. Results A total of 112 boys underwent laparoscopic inguinal hernia repair with 100 available for complete follow-up and data analysis. One hundred twenty-five inguinal (25 bilateral) hernia repairs were performed. Group 1 had 80 testis units. There was no significant difference in values of RI between preoperative, early postoperative, and late postoperative periods. Group 2 had 45 testis units. Resistive index could not be calculated. Seventy-five percent showed only systolic blood flow on spectral analysis; hence, RI, 1; and the rest showed the presence of blood flow on power Doppler scan. All testis units consistently showed blood flow in the early and late postoperative period. No testicular atrophy was found at 6-month follow-up examination on DUS. Conclusion Laparoscopic repair of inguinal hernia in children does not affect testicular perfusion or growth.