Preserving the continuity of round ligament along with hernia sac in indirect inguinal hernia repair in female children does not increase the recurrence rate of hernia. Experience with 217 cases

Abstract

In the standard classical method of indirect inguinal hernia (IIH) repair in female children, after transligation of hernia sac along with round ligament at the level of internal ring, the distal portion is divided or cut off, thereby removing a possible future support for the internal genital organs. In this article, we propose a modification to the standard technique for IIH repair which preserves the continuity of round ligament along with hernia sac without increasing the recurrence rate. In a 3-year prospective clinical trial, from March 2007 to March 2010, IIH repairs were performed on 217 female children. In all of these cases, the hernia sac along with round ligament is only transligated at the level of internal ring and a window is created in the distal portion of the sac to prevent a hydrocele formation and the continuity of round ligament along with hernia sac was preserved. The charts of these patients were then analyzed to determine if recurrence had occurred. In addition, we noted any other early postoperative complications such as wound infection, bleeding, and tolerance. Within the 25-month mean follow-up period (6-36 months), none of the patients developed any of the above-mentioned complications. The most important result of this study was that preserving the continuity of round ligament along with hernia sac did not increase the rate of recurrence. On the basis of results obtained from this study, we conclude that preserving the continuity of round ligament along with hernia sac in female children during IIH repair does not increase the rate of recurrence, and is less intrusive to the normal anatomy of the inguinal region and needs less time to do.