Laparoscopically assisted repair of inguinal hernia through a micro-incision and extra-peritoneal division and ligation of the hernia sac

Abstract

High ligation and division of the hernia sac are the two important steps in open pediatric indirect inguinal hernia repair. We describe a laparoscopically assisted method of delivering the hernia sac through a 5-mm micro-incision with complete division and high ligation of the hernia sac similar to the open repair method. A new laparoscopic technique of pediatric inguinal hernia repair which allows high ligation, complete division and removal of the indirect inguinal hernia sac is described. Twenty-six patients (15 boys, 11 girls) underwent laparoscopic inguinal hernia repair. The mean age was 40 months. 13 patients had bilateral inguinal hernia repair. There were no intra-operative complications and at mean follow-up of 6 months, there was 1 recurrence. No other complications (wound infection, suture granuloma formation, hydrocele) were seen post-operatively. This new laparoscopically assisted inguinal hernia repair technique combines the advantages of standard open method and laparoscopy. The efficacy of this repair will need confirmation with a longer follow-up and a larger patient series. The effect of traction on cord structure will need to be monitored.