Repair Of Indirect Inguinal Hernia Research Articles

Trans-Abdominal Pre-Peritoneal (TAPP) Approach for Anatomical Repair of Direct Inguinal Hernia in Children: Could it Be the New Standardized Approach?

BackgroundThe incidence of direct inguinal hernia in the pediatric population is relatively low and is usually discovered intraoperatively, rendering it unfamiliar to most pediatric surgeons. The traditional approach involves directly addressing the peritoneal defect, which includes dissecting the sac and repairing the peritoneum, reinforced with the umbilical ligament. In this paper, we present our experience with a novel approach to anatomical repair utilizing a non-mesh transabdominal preperitoneal (TAPP) approach. MethodsThis a retrospective case series of direct inguinal hernia that were operated laparoscopically using the novel approach of repair from January 2018 to January 2024. Data were analyzed for demographics, presentation, type of defect, operative time, complications, and recurrence. The new approach utilizes the pre-peritoneal approach to delineate the exact facial defect then, primary anatomical repair is established using 2/0 non-absorbable braided sutures. Finally, closure of the peritoneum was performed using running 4/0 absorbable sutures.This is a retrospective case series of direct inguinal hernias that were operated on laparoscopically using the novel repair approach from January 2018 to January 2024. Data were analyzed for demographics, presentation, type of defect, operative time, complications, and recurrence. The new approach employs the pre-peritoneal approach to accurately delineate the fascial defect, followed by primary anatomical repair using 2/0 non-absorbable braided sutures. Finally, the peritoneum is closed using running 4/0 absorbable sutures. ResultsData from nine cases were included. Six cases were on right side, and three cases were on left side. Patients were predominantly boys (8 boys and 1 girl). The mean age at operation was 25.1 months (range:11 month to 5 years). Four patients had previous indirect inguinal hernia repair on the same side. The mean operative time was 34 ± 9 min. No intraoperative complications occurred. The median follow up period was 24 months with no recurrence was detected in any of the cases. ConclusionThe non-mesh TAPP approach offers excellent exposure of the fascial structures, facilitating accurate identification and repair of the defect. Despite being technically demanding, it allows for the establishment of a robust anatomical repair. No recurrences occurred in the study group; however, a longer follow up and a larger sample are needed to provide more reliable evaluation. Level of EvidenceIII.

Laparoscopic Totally Extraperitoneal (TEP) Left Indirect Inguinal Hernia Repair with Mesh

Laparoscopic Totally Extraperitoneal (TEP) Left Indirect Inguinal Hernia Repair with Mesh

Laparoscopic Sac Disconnection and Peritoneal Closure of Pediatric Inguinal Hernia.

Background: Laparoscopic sac disconnection and peritoneal closure represents an alternative to open pediatric hernia repair. We performed a retrospective review of our data to evaluate this alternative method. Materials and Methods: With REB approval, a retrospective chart review of all patients who underwent laparoscopic indirect inguinal hernia repair between June 2013 and July 2016 was conducted. Primary outcome was the recurrence rate. Secondary outcomes included length of surgery, postoperative hydrocele, and perioperative complications. Data were extracted from EPIC Hyperspace onto a standardized data extraction form. Results: A total of 243 patients were included, of which 82% were males. Age ranged from 1 month to 17 years of age. A total of 322 defects were repaired. Eighty (32%) had contralateral patent processus vaginalis. Twelve (4%) patients presented with incarceration and three (1.2%) had a direct inguinal hernia defect. Recurrence rate was 0.6% (n = 2). There were no intraoperative complications. Operative time was an average of 40 and 54 minutes for unilateral and bilateral repairs, respectively. No testicular ascents, testicular atrophy, vas deferens injury, postoperative hydroceles, and wound infections were reported. Conclusion: Laparoscopic sac disconnection and peritoneal closure of pediatric inguinal hernia is a safe, feasible method with one of the lowest reported recurrence rate among the other laparoscopic methods.

Higher rate of chronic pain in young men after open mesh vs nonmesh repair of elective primary unilateral indirect inguinal hernia: A nationwide questionnaire study

PurposeYoung age is a risk factor for chronic pain after inguinal hernia repair, but the role of the mesh in young patients is uncertain. The aim of this study was to assess chronic pain after open mesh versus non-mesh repair of indirect inguinal hernia in young men. Materials and methodsValidated questionnaires were sent to men aged 18–29 years at the time of an elective primary unilateral open repair of an indirect inguinal hernia between 1998 and 2015. Patients were identified in the Danish Hernia Database. Non-mesh repairs were matched 1:3 with mesh repairs (Lichtenstein) on age and follow-up time. The primary outcome was the proportion of patients with chronic pain evaluated with the Activity assessment scale. Secondary outcomes included other pain measures and sexual impairment. ResultsIn total, 661 patients were included in this study (77% mesh and 23% non-mesh) with a median follow-up of 14.8 years (range 2.3–20.0) in the mesh group and 15.9 years (range 3.6–20.0) in the non-mesh group. For the primary outcome, 12% of patients in the mesh group compared with 6% in the non-mesh group had chronic pain (p=0.03). Patients in the mesh group had higher odds of chronic pain in adjusted analysis (OR=2.30 [95% confidence interval=1.11–4.77]). More patients in the mesh group had pain during sexual activity (p=0.01), but there were no differences for most of the remaining secondary outcomes. ConclusionYoung men had a higher rate of chronic pain after open mesh compared with non-mesh repair for indirect inguinal hernia, but results should be interpreted with caution.

Sac invagination versus sac ligation in open Lichtenstein repair of indirect inguinal hernia: A systematic review and meta-analysis of randomized controlled trials

BackgroundTo compare the outcomes of sac invagination and sac ligation in patients undergoing open Lichtenstein repair of indirect inguinal hernia. MethodsA systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards was conducted to identify all randomized controlled trials comparing the outcomes of sac invagination and sac ligation in patients undergoing open Lichtenstein repair of indirect inguinal hernia. Random effects modeling was applied to calculate pooled outcome data. ResultsAnalysis of 843 patients with 851 hernias from 6 randomized controlled trials suggested no difference between the sac invagination and sac ligation techniques in terms of recurrence (risk difference: 0.00, P = .91), chronic pain (risk difference: 0.00, P = .98), operative time (mean difference: –0.15, P = .89), hematoma (odds ratio: 0.93, P = .93), seroma (odds ratio: 1.00, P = 1.00), surgical site infection (odds ratio: 1.68, P = .40), or urinary retention (odds ratio: 0.85, P = .78); however, ligation of sac resulted in more early postoperative pain as measured by visual analog scale score at 6 hours postoperatively (mean difference: –0.92, P < .00001), at 12 hours postoperatively (mean difference: –0.94, P = .001), at 24 hours postoperatively (mean difference: –1.08, P < .00001), and on day 7 postoperatively (mean difference: –0.99, P = .009). The quality and certainty of the available evidence were moderate. ConclusionEvidence from randomized controlled trials with moderate certainty suggests that ligation of indirect inguinal hernia sac during open Lichtenstein repair may not improve the outcomes regarding recurrence, chronic pain, or operative complications but may result in more early postoperative pain. Future randomized controlled trials with more robust statistical power and methodological quality would help improve the available evidence's certainty.

P-036 SUTURING OF THE INTERNAL INGUINAL ORIFICE DURING THE LAPAROSCOPIC TRANSABDOMINAL REPAIR OF A LARGE INDIRECT INGUINAL HERNIA

Abstract Aim To present the rationale and surgical technique of the internal inguinal orifice suturing during transabdominal preperitoneal hernia repair of large inguinal hernias. Methods The surgical steps of a laparoscopic transabdominal preperitoneal hernia repair (TAPP) with the addition of the suturing reconstruction of the internal orifice are presented. Results A 52-year-old man presented with a large symptomatic right inguinal hernia. A TAPP repair was performed. Due to a significantly widened internal inguinal orifice, reconstruction of the deep ring was performed by suturing the transversalis fascia arc to the iliopubic tract with a self-locking 2-0 stitch in a continuous fashion. Accordingly, a medium-weighted polyester mesh was applied. The patient had an uneventful postoperative period, without symptoms of chronic pain or discomfort at a 6-month follow-up. Conclusions During the laparoscopic repair of large indirect inguinal hernias, suturing reconstruction of the internal orifice, similar to the common practice for open inguinal hernia repair, may reduce mesh eventration and recurrence.

Novel modification of Marcy operation for indirect inguinal hernia reconstituting deep inguinal ring shutter action.

The two most frequent and significant complications after inguinal hernia repair are hernia recurrence and post-herniorrhaphy chronic pain. To add anatomic and physiologic strength to the tissue repair, especially in indirect inguinal herniorrhaphy, we devised a modification of Marcy operation that can reconstitute inguinal shutter action more efficiently by changing the direction of the sutures vertical to horizontal. During 36months from 1st Jan. 2019, 148cases of 140 patients were operated for Indirect inguinal hernia or Pantaloon hernia (11 cases). 145 indirect inguinal herniorrhaphy were performed exclusively with author's modification of Marcy operation. Hernia recurrence during the follow-up period (3months-36months), and postoperative chronic pain at 3months after herniorrhaphy were analyzed. 104 cases among the 145 indirect inguinal hernia (71.7%) were operated with only deep inguinal ring (DIR) reconstruction as author modified. In 41 cases (28.3%), posterior wall reconstruction was done simultaneously. There was no recurrence or reoperation case during the follow-up period. The incidence of postoperative chronic pain at postoperative 3months of VAS greater than 3.0 was 2.2% (3 cases). Author's modification of Marcy operation was feasible anatomically in all indirect inguinal hernia repair, which is theoretically superior to classic Marcy operation in that repositioning the DIR more laterally and securing the obliquity and shutter action of the DIR. Result is at least not inferior in the aspect of short-term recurrence and chronic post-herniorrhaphy pain.

Effect of complete reduction of hernia sac and transection of hernia sac during laparoscopic indirect inguinal hernia repair on seroma

IntroductionThis study investigated the effect of complete reduction and transection of the hernia sac during laparoscopic indirect inguinal hernia repair on seroma.MethodsRetrospective analysis was performed on 1763 cases undergoing laparoscopic indirect inguinal hernia repair in three centers from January 2017 to September 2019, among them, 311 patients with transection of hernia sac and 1452 patients with reduction of hernia sac, the data of the two groups were tested by t-test. Logistic univariate analysis was performed on 233 cases of postoperative seroma, and variables p < 0.05 in univariate analysis were included for multivariate analysis. Then, the transection group and the reduction group were matched with 1:1 propensity score matching, and the caliper value was set at 0.05. Finally, 274 patients matched in each group were analyzed by univariate analysis again to evaluate whether the transection of hernia sac had an impact on postoperative seroma.ResultsThe results of univariate analysis of 233 patients with postoperative seroma showed that: ASA-3 p = 0.031, classification-L3 p < 0.001, surgery-TEP p < 0.001, transect group p = 0.005. The results of multivariate analysis show that: ASA-3 p < 0.001, classification-L3 p < 0.001, surgery-TEP p < 0.001, transect group p = 0.020. The results of univariate analysis after propensity score matching showed that transection of the hernia sac is significant for postoperative seroma (p < 0.001).ConclusionTransection of the hernia sac during laparoscopic indirect inguinal hernia repair can significantly lead to postoperative seroma.

Clinical Effect of Clinical Nursing Pathway Applied in Tension-free Repair of Indirect Inguinal Hernia during Perioperative Period

Clinical Effect of Clinical Nursing Pathway Applied in Tension-free Repair of Indirect Inguinal Hernia during Perioperative Period

Transversus Abdominis Plane Block Versus Local Anesthetic Wound Infiltration for Postoperative Analgesia in Adult Patients Undergoing Hernia Repair in Daycare Procedure: A Randomized Control Trial.

Introduction: Various modalities are now being used to manage postoperative pain, such as regional nerve blocks techniques, continuous epidural analgesia, patient-controlled analgesia, opioids, and systemic non-steroidal anti-inflammatory drugs. This study compared the mean postoperative pain score between ultrasound-guided transversus abdominis plane (TAP) block and a local anesthetic wound infiltration at the surgical incision site.Methodology: A prospective, comparative, randomized controlled trial (RCT) was carried out from February 2021 to September 2021. The study was conducted in the anesthesia department of Dow University of Health Sciences, Karachi, Pakistan. Patients aged 18-80 years presenting with elective surgery of (both direct and indirect) inguinal hernia repair were enrolled in the study. Participants were randomly assigned into one of the two groups that are local anesthetic wound infiltration (Group A) and TAP block (Group B). The mean pain score was assessed using a visual analog scale and compared between the two groups.Results: The study included 168 patients grouped in two different groups. The mean age in Group A was 43.87 (+17.21), and Group B was 47.01 (±15.37). Mean pain scores in groups A and B were 6.36±1.94 vs 4.51 ± 1.99 (p-value=0.001). The pain rescue medications were given to 57.14% of patients in Group A and 34.52% of patients in Group B, and it was significantly different in the two groups (p-value=0.003). It was found that patients in Group A reported more severe pain (41.67%) than patients in Group B (10.71%).Conclusion: When compared to local anesthetic wound infiltration, ultrasound-guided TAP block had better analgesic activity compared to local anesthetic wound infiltration.

Surgical Repair of Indirect Inguinal Hernia in Bonnet Macaque (Macaca radiata)

Background:Hernia is a protrusion of an organ from the wall of the cavity bearing it. Omentum, adipose tissue, and intestinal loops are the most frequently involved organs. The present case report is a rare case of indirect inguinal hernia having omentum engaged in scrotum through hernial ring in a bonnet macaque (Macaca radiata) and its surgical management.Case Description:A 19-year-old male bonnet macaque was presented with distension of the right inguinal and scrotal region. Physical examination revealed an inguinal hernia. Surgical intervention was deemed necessary considering the state of the animal. The herniation was surgically corrected by the removal of the protruded fatty mass. The monkey was kept in strict confinement till complete healing. The animal recovered uneventfully in 2 weeks without any post-operative complications. This case report details a successful surgical repair of an indirect inguinal hernia in a bonnet macaque.Conclusion:Based on the present case study, it is concluded that surgery can be an ideal and effective option for the treatment of inguinal hernias in primates.

Feasibility of laparoscopic indirect inguinal hernia repair with lateral umbilical fold covering internal inguinal ring combined with patch repair.

For an indirect inguinal hernia (IIH), it is a challenge to repair the internal inguinal ring (IIR) with self-tissue reconstruction in laparoscopic repair. To evaluate the efficacy and safety of covering the IIR with the lateral umbilical fold (LUF) combined with patch repair in laparoscopic indirect inguinal hernia repair. Patients with IIH treated by trans-abdominal preperitoneal (TAPP) hernia repair at the Department of General Surgery, Shanghai Public Health Clinical Centre between September 2019 and March 2021 were retrospectively analyzed. In group I (n = 57) the LUF was overturned and sutured to cover the IIR under a laparoscope and subsequently repaired with a patch. In group II (n = 62), the IIR was not covered by the LUF but only repaired with a self-gripping mesh. We noted a longer suture time in group I than in group II. Although the LUF was covered after suturing, no significant difference in postoperative pain was observed between the two groups. However, significant differences in surgery time and hospitalization cost (p < 0.05) were found. One case of recurrence was observed in group II. The LUF can be used in IIH to cover the IIR and is a feasible approach. The LUF covering the IIR has no significant difference in pain.

Comparison of post-operative pain after laparoscopic total extraperitoneal mesh repair of indirect inguinal hernia with tacker

Objectives: To compare the post-operative pain after laparoscopic total extraperitoneal mesh repair of indirect inguinal hernia with tacker and without tacker fixation. Materials &amp; Methods: This comparative study was done at Surgical Department of Bahawal Victoria Hospital, Bahawalpur from May 2020 to November 2020 over the period of 6 months. Total 182 patients with indirect inguinal hernia, having age range from 20 to 60 either male or female were selected. In group A patients, laparoscopic TEP mesh repair of inguinal hernia without tacker fixation was done while in group B patients, laparoscopic TEP mesh repair of inguinal hernia with tacker fixation was done. Patients were assessed for post-operative pain and outcome (satisfactory/unsatisfactory) at 1 month follow up. Results: Average of patients was 41.33 ± 12.37 years and 40.83 ± 12.04 years in group A and group B. Out of 182 patients, 170 (93.41%) were males and 12 (6.59%) were females. Mean post-operative pain in Group A was 1.46 ± 1.50 while in Group B was 1.77 ± 2.08 (p-value=0.2505). Satisfactory outcome was noted in 84 (92.31%) patients and 67 (73.63%) patients of group A and B and the difference was significant (P = 0.001). Conclusion: Results of this study showed that there is a significant difference of satisfactory outcome (less post-operative pain) between the non-fixation and fixation group. Difference of satisfactory outcome was also significant between male patients, diabetics and obese patients of both groups. Keywords: Inguinal hernia, laparoscopic, mesh, tacker fixation

Assessment of the daVinci Single Port (SP) Robotic Platform on Indirect Inguinal Hernia Repair in Adolescents

Assessment of the daVinci Single Port (SP) Robotic Platform on Indirect Inguinal Hernia Repair in Adolescents

Inguinal Hernia Repair with Laparoscopic-Supported Percutaneous Internal Ring Suturing Technique in Children - One Center Experience

Objective: High ligation of the hernia sac is applied as the basic principle in inguinal hernia surgery. Nowadays, it is possible to perform inguinal hernia surgeries with minimally invasive methods and with the help of technological developments with the same success rates. One of these minimally invasive methods is the percutaneous internal ring suturing method, assisted by laparoscopy. In this study, we aimed to present the case series that we treated with a laparoscopy-assisted percutaneous internal ring suturing and its results up to six months after surgery. Material and Methods: Pediatric patients admitted to the Pediatric Surgery Clinic of Our Hospital with indirect inguinal hernia between November 01, 2019, and February 29, 2020, were included in the study. Patients with clinical features of incarcerated inguinal hernia were excluded from the study. Inguinal hernia repair was performed by the percutaneous internal ring suturing method supported by laparoscopy. Results: During the study period, 36 inguinal hernia repairs were performed in 27 patients. The distribution of age groups is over 24 months (8/27), 2-6 months (5/27), 6-12 months (4/27), and 12-24 months (1/27). No patient required open surgical technique or the use of additional trocars. The mean operation time was 24.3±1.77 minutes. The mean hospitalization period of the patients was 2.15±0.12 days. During the follow-up of the patients, no recurrence, intra-abdominal complication, or inguinal complication was detected. Conclusion: We found that the percutaneous internal ring closure method applied under laparoscopic support in childhood is an easy and safe method for indirect inguinal hernia repair.

The Management of Indirect Inguinal Hernia Sac in Laparoscopic Inguinal Hernia Repair: A Systemic Review of Literature.

The aim of this study is to investigate the current management strategy of indirect hernia sac during laparoscopic inguinal hernia repair. The aim was to evaluate the various indirect hernia sac management strategies when performing laparoscopic inguinal hernia repair. Major databases (PubMed, Embase, Springer, and Cochrane Library). MeSH and free-text searching include "laparoscopic inguinal hernia" "TAPP," "TEP," "inguinal hernia," "indirect inguinal hernia sac," "distal sac," "sac transection," "sac ligation," and "sac reduction." The present study enrolled 7 trials, 4 studies compared the results of indirect hernia sac transection and complete sac reduction. The pooled results indicated that indirect hernia sac transection was associated increased seroma formation (odds ratio=2.74, 95% confidence interval: 1.41-4.31), and there was no statistical difference in the incidence of postoperative pain, operative time, hernia recurrence, and time to return to normal activity between the sac transection and sac reduction groups. Two studies reported the application of adjuncts in the management of distal sac during laparoscopic large inguinoscrotal hernia repair. The seroma formation could be reduced by adjuncts of fixing the distal hernia sac to posterior abdominal wall with either suture or tacks. Indirect sac transection during laparoscopic indirect inguinal hernia repair is associated with a higher incidence of postoperative seroma. Additional adjuncts to the divided distal hernia sac, including distal sac fixation with either suture or tacks, are effective methods to prevent postoperative seroma.

A new self-made electric hook for laparoscopic inguinal hernia repair

Background: Current investigation was conducted to explore the clinical application of self-made electric hook in laparoscopic indirect inguinal hernia repair.Methods: Randomized controlled trial was conducted that compared two groups of patients who underwent laparoscopic inguinal hernia repair from 2013 to 2017 at our institution. A laparoscopic indirect inguinal hernia repair with beak-like electrocoagulation instrument as modified trans-abdominal preperitoneal prosthesis was performed on 42 patients. As a comparison, 40 patients with traditional TAPP were collected and analyzed. In the end, we compared the operation time, blood loss, complications, and recurrence of two groups.Results: 82 patients have successfully completed surgery without conversion to open inguinal hernia repair. Patients were follow-up visited for 18 to 78 months, and no recurrence was found. 1 case of scrotal edema occurred using a self-made electric hook in modified TAPP, and cured by conservative treatment. In traditional TAPP group, there was 1 case of postoperative seroma, which cured by conservative treatment. There was no significant difference between these 2 groups in terms of complications and recurrence (p&gt;0. 05). However, the differences in operation time and blood loss were significant (p&lt;0. 05).Conclusions: Self-made electrical hook showed in laparoscopic inguinal hernia repair of indirect inguinal hernia has the advantages of shortening operation time, reducing bleeding, easing the difficulty of operation, and improving the safety of surgery, it is worthy of further clinical application.

Indirect inguinal hernia repair conducted with single conventional port intracorporeal conventional equipment-endoscopic surgery.

Laparoscopic or laparoscopy-assisted inguinal hernia repair (IHR) can be performed using one port plus two stab wounds. We herein present our experience with laparoscopic IHR conducted using a single conventional port and a single working instrument. The records patients who underwent single conventional port intracorporeal IHR during November 2013-December 2018 were evaluated. The main outcome measurements were patient's demographic characteristics, hernia side, presence of incarceration, operative time, and complications. A total of 132 inguinal hernias (52 right, 40 left, and 20 bilateral) were repaired in 112 patients (76 boys, 36 girls). The mean ages of the patients were 69.8 ± 53.4months (3months to 17years). In six patients, contralateral processus vaginalis was found to be patent during operation. Incarcerated inguinal hernia was present in two patients. Mean operative time was 17.9 ± 3.8min (9-30min) in unilateral hernias and 28.9 ± 6.5min (24-45min) in bilateral hernias. No intraoperative and postoperative complications were encountered. The mean hospital stay of the patients was 8.8 ± 5.0h (4-36h). Postoperative follow-up was 16.5 ± 5.1months (6-24months). No recurrent inguinal hernias were detected during follow-up. Single conventional port intracorporeal IHR obviates additional stab wounds. Additionally, present technique eliminates the risk of skin puckering, subcutaneous granuloma, infection, nerve, and muscle damage development induced by the subcutaneously placed knot in laparoscopy-assisted IHR. Single conventional port intracorporeal IHR in children is a feasible and safe operative technique with low complication rates.

Duplicated vas deferens as an incidental finding during indirect inguinal hernia repair: A case report and literature review.

Duplication of vas deferens is an anomaly that is generally encountered during inguinal hernia repair, orchiopexy, radical prostatectomy, varicocelectomy, and vasectomy. The estimated rate of this anomaly in the United States is 0.01%. This anomaly may predispose to iatrogenic vas deferens injury during inguinal hernia repair. Embryological point of view suggests that the duplication of the mesonephric duct system could result in duplicated vas deferens. Failure to recognize this anomaly may lead to injury, obstruction, or spermatic granuloma. Furthermore, it is important to identify duplicated vas deferens during vasectomy to avoid failure of the procedure. Identification of duplicated vas deferens is important during inguinal hernia surgery, vasectomy, and varicocelectomy. Herein, we report a case of duplicated vas deferens during open indirect inguinal hernia repair.

The Ideal Candidate for Subcutaneous Endoscopically Assisted Ligation (SEAL) of the Internal Ring for Pediatric Inguinal Hernia Repair

Subcutaneous endoscopically assisted ligation (SEAL) technique is an effective and minimally invasive approach for indirect inguinal hernia repair in children. Not all patients are candidates for SEAL because of technical limitations. We hypothesized that preoperatively assessed patient-level factors may predict technical feasibility of SEAL repair. We performed a retrospective review of all patients who underwent indirect inguinal hernia repair between June 2012 and December 2014. All patients younger than two years and any patient older than two years who had a concomitant umbilical hernia were considered candidates for diagnostic laparoscopy with SEAL repair. We compared patients who had SEAL repair with those who had diagnostic laparoscopy with conversion to open repair. Univariate statistics was performed using the chi-squared and Student's t test. One hundred forty-one patients underwent diagnostic laparoscopy with intent to perform a SEAL repair. Seventeen patients were lost to follow-up. Of the remaining 124 patients, 66 had SEAL repairs, 35 had open repairs, and 23 had a SEAL repair with contralateral open repair. Patient age, BMI, gender, history of prematurity, and history of incarcerated hernia were similar between the SEAL and open groups. Sixty-two per cent of hernias were able to be repaired with SEAL technique. Hernia recurrence was seen in 3 of 123 total SEAL repairs and in 1 of 74 open repairs. The recurrence rate for SEAL repairs (2.4%) was not significantly different from the recurrence rate for open repairs (1.4%). No preoperative patient-level factors predicted technical inability to perform a successful SEAL repair. In this series, the recurrence risk of SEAL compared with open repair was low and not statistically significant. For practitioners with minimally invasive experience, SEAL should be considered a safe and successful option for inguinal hernia repair in pediatric patients undergoing routine diagnostic laparoscopy.