Laparoscopic repair of sliding inguinal hernia in children: a report of 10 cases

Abstract

Objective The aims of this study are to evaluate the clinical characteristics of sliding inguinal hernia in children, and to evaluate the safety and feasibility of laparoscopic repair of sliding inguinal hernia. Methods Laparoscopic percutaneous extraperitoneal closure (LPEC) was performed in 283 inguinal hernia children admitted to Binzhou Medical University Hospital from March 2014 to February 2016. Ten of these patients were associated with sliding inguinal hernia, and these 10 patients were enrolled and reviewed retrospectively. The clinical data of their operating time, blood loss, length of stay, postoperative complications, and hernia recurrence were analyzed with statistical method. Results There are 3 boys and 7 girls; the median age was 20.4 months; six patients were on left side (60%) and four patients were on right side (40%). Two were irreducible (20%) and three were incarcerated inguinal hernia (30%). One hernia content had appendix, one had appendix and cecum, one had sigmoid colon, three had ovary, four had Fallopian tube. The operation time was 25 to 60 minutes [mean (37.6±13.1)minutes]. the intraoperative blood loss was 2 to 10 ml (mean 3.95±2.26 ml), the length of hospital stay was 5 to 7 days [an average of (5.6±0.8)days]. Two contralateral patent processus vaginalis were detected and to perform LPEC simultaneously. There were no conversion to the inguinal approach in all patients. All of the patients were followed up for 6 to 18 months and no recurrence was found. Other postoperative complications were not observed. Conclusion Most of sliding inguinal hernia in children were the type II of Bendavid Classifications. The reduction of the sac is easier by LPEC approach and to confirm that the viscera actually forms the wall of the sac, thereby reducing the incidence of access related injuries and viscera injuries. The reduction of the sac completely and high ligation of the sac are the essential measures to reduce the risk of recurrence. LPEC is safe and feasible for the sliding inguinal hernia repair in children in the near future, and the long-term effect remains to be seen. Key words: Sliding inguinal hernia; Herniorrhaphy; Laparoscopes; Children