Laparoscopic Totally Extraperitoneal Repair in a Pediatric Patient for Recurrent Inguinal Hernia

Abstract

Abstract Introduction: Laparoscopic totally extraperitoneal (TEP) inguinal hernia repairs are common in adults but have not previously been reported in the pediatric population. This video, with a run time of 4 minutes 46 seconds, demonstrates an effective laparoscopic TEP repair in a 10-year-old boy presenting with a recurrent left inguinal hernia after three previous failed anterior repairs, including prior synthetic absorbable mesh placement. Methods: Given the likelihood of significant scarring and possible inguinal floor weakness, an anterior approach was felt to carry a high risk of injury in this patient. We decided to perform a laparoscopic TEP repair to minimize the chance of damage to cord structures with lightweight polypropylene mesh placement to reinforce the repair. Results: Access to the extraperitoneal space is obtained through a 10-mm infraumbilical incision in standard manner; two 5-mm ports are placed lateral to midline to increase the working space in a smaller body habitus. Blunt diss...