Needlescopic inguinal herniorrhaphy in children - A new simplified technique

Abstract

Needlescopic techniques have been used recently in repairing inguinal hernias (IH), which has made this type of surgery more feasible and less invasive. The technique is being developed further. The objective of this study is to describe and assess the results that can be achieved by using a new simplified techinque (Reverdin needle, RN) in needlescopic inguinal herniorrhaphy (NH) in children. All patients with symptomatic IH confirmed by clinical examination were subjected to elective needlescopic herniorrhaphy. One-hundred and fifty patients with 186 groin hernias, from two hospitals in Egypt and Saudi Arabia, in the period from October 1999 to May 2002, were assinged to NH using RN. The RN was used to insert a purse-string suture around the internal inguinal ring (IIR) to be tied extracorporeally. A total of 186 IH defects in 150 children were repaired successfully. There were 130 males and 20 females with a mean age of 20.58 + 21 months (range 8-96 months). Right-sided IH was present in 86 patients (57.33%); among these patients, an opened IIR was found and repaired in 12 cases (8%). Left-sided IH was present in 30 cases (20%), bilateral hernia in 19 cases (12.67%), and recurrent IH in 20 cases (10%). The mean duration of surgery was 8.7 + 1.18 min for unilateral and 12.35 + 2 min for bilateral hernia repair. No intra or postoperative complications. The mean hospital stay was 7.79 + 1.28 h. The new technique had all the advantages of needlescopic herniorrhaphy in children (less invasive, less pain, short hospital stay) combined with the advantages of reduced operating time, simplicity, and feasibility. It may be preferable for the intracorporeal suturing and knot tying. However, it needs long-term follow up.