World Journal of Laparoscopic Surgery

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VOLUME 12 , ISSUE 2 ( May-August, 2019 ) > List of Articles

Original Article

Laparoscopic Herniotomy in Female Children: Our Experience in 110 Patients

Chalapathi Gontumukkala, Ramana NG Venkata, Rajeev K Golimi, Veera S Javvadi

Keywords : Hernia, Laparoscopy, Percutaneous internal ring suturing

Citation Information : Gontumukkala C, Venkata RN, Golimi RK, Javvadi VS. Laparoscopic Herniotomy in Female Children: Our Experience in 110 Patients. World J Lap Surg 2019; 12 (2):68-72.

DOI: 10.5005/jp-journals-10033-1375

License: CC BY-NC 4.0

Published Online: 01-08-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim of the study: To assess the results and complications of laparoscopic herniotomy in female children using percutaneous internal ring suturing (PIRS). Materials and methods: One hundred and ten consecutive female children who were admitted with a unilateral or bilateral inguinal hernia from January 2015 to June 2018 to a medical college referral hospital were included in the study. The technique used was PIRS, using spinal needle 23 gaze and 3.0 prolene. All patients were followed up postoperatively. Babies with recurrent hernias and complicated inguinal hernia were excluded from this study. Results: A total of 110 female children with unilateral or bilateral inguinal hernia were included in the study. Age ranged from 1 month to 15 years with a mean age of 3 years. The clinically unilateral hernia was present in 80 children but the patent internal ring was present on the contralateral side in 25 children and was repaired simultaneously. The bilateral inguinal hernia was present in 30 children. The total number of hernia units was 165. The mean operative time was 15 minutes, ranging from 12 minutes to 20 minutes for unilateral hernia and 15–30 minutes for a bilateral hernia. The mean postoperative stay was 1 day. The follow-up period ranged from 7 days to 2 years. Two babies had hematoma at the internal ring during the procedure, subsided with no postoperative sequel. One child developed hernia on contralateral side, who was operated for contralateral patent ring during repair of an ipsilateral clinical hernia. None other children who were operated for clinical hernia had a recurrence. Conclusion: Laparoscopic herniotomy using the technique of PIRS is safe, quick with minimal postoperative pain, and short hospital stay, and had a very low incidence of recurrence.


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  1. Kapur P, Caty MG, Glick PL. Pediatric hernias and hydroceles. Pediatr Clin North Am 1998;45(4):773–789. DOI: 10.1016/S0031-3955(05)70044-4.
  2. Lukong CS. Surgical techniques of laparoscopic inguinal hernia repair in children: a critical appraisal. J Surg Tech Case Rep 2012;4(1):1–5. DOI: 10.4103/2006-8808.100343.
  3. Cox JA. Inguinal hernia of childhood. Surg Clin North Am 1985;65(5):1331–1342. DOI: 10.1016/S0039-6109(16)43742-4.
  4. Tackett LD, Breuer CK, Luks FL, et al. Incidence of contralateral inguinal hernia: a prospective analysis. J Pediatr Surg 1999;34(5):684–687. DOI: 10.1016/S0022-3468(99)90356-1.
  5. El-Gohary MA. Laparoscopic ligation of inguinal hernia in girls. Pediatr Endosurg Innov Tech 1997;1(3):185–188. DOI: 10.1089/pei.1997.1.185.
  6. Prasad R, Lovvorn HN, Wadie GM, et al. Early experience with needleoscopic inguinal herniorrhaphy in children. J Pediatr Surg 2003;38(7):1055–1058. DOI: 10.1016/S0022-3468(03)00191-X.
  7. Lee KH, Yeung CK. Laparoscopic surgery in newborns and infants: an update. HK J Paediatr 2003;8:327–335.
  8. Patkowski D, Czernik J, Chrzan R, et al. Percutaneous internal ring suturing: a simple minimally invasive technique for inguinal hernia repair in children. J Laparoendosc Adv Surg Tech A 2006;16(5): 513–517. DOI: 10.1089/lap.2006.16.513.
  9. Rathauser F. Historical overview of the bilateral approach to pediatric inguinal hernias. Am J Surg 1985;150(5):527–532. DOI: 10.1016/0002-9610(85)90430-1.
  10. Rowe MI, Copelson LW, Clatworthy HW. The patent process vaginalis and the inguinal hernia. J Pediatr Surg 1969;4(1):102–107. DOI: 10.1016/0022-3468(69)90189-4.
  11. Steinau G, Treutner KH, Feeken G, et al. Recurrent inguinal hernias in infants and children. World J Surg 1995;19(2):303–306. DOI: 10.1007/BF00308645.
  12. Grosfeld JL, Minnick K, Shedd F, et al. Inguinal hernia in children: factors affecting recurrence in 62 cases. J Pediatr Surg 1991;26(3): 283–287. DOI: 10.1016/0022-3468(91)90503-L.
  13. Chan KL, Hui WC, Tam KH. Prospective, randomized, single-center, single-blind comparison of laparoscopic vs open repair of pediatric inguinal hernia. Surg Endosc 2005;19(7):927–932. DOI: 10.1007/s00464-004-8224-3.
  14. Schier F, Montupet P, Esposito C. Laparoscopic inguinal herniorrhaphy in children: a three-center experience with 933 repairs. J Pediatr Surg 2002;37(3):395–397. DOI: 10.1053/jpsu.2002.30842.
  15. Chinnaswamy P, Mallabiv V, Jani KV, et al. Laparoscopic inguinal hernia repair in children. JSLS 2005;9(4):393–398.
  16. Schier F. Laparoscopic inguinal hernia repair - a prospective personal series of 542 children. J Pediatr Surg 2006;41(6):1081–1084. DOI: 10.1016/j.jpedsurg.2006.02.028.
  17. Verma D, Ram D, Gupta M, et al. Laparoscopic herniotomy-A single centre study of 150 cases. Am J Clin Exp Med 2017;5(5):181–185. DOI: 10.11648/j.ajcem.20170505.15.
  18. Spurbeck WW, Prasad R, Lobe TE. Two-year experience with minimally invasive herniorrhaphy in children. Surg Endosc 2005;19(4):551–553. DOI: 10.1007/s00464-004-8922-x.
  19. Kastenberg Z, Bruzoni M, Dutta S. A modification of the laparoscopic transcutaneous inguinal hernia repair to achieve transfixation ligature of the hernial sac. J Pediatr Surg 2011;46(8):1658–1664. DOI: 10.1016/j.jpedsurg.2011.03.022.
  20. Ozgediz D, Roayaie K, Lee H, et al. Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: report of a new technique and early results. Surg Endosc 2007;21(8):1327–1331. DOI: 10.1007/s00464-007-9202-3.
  21. Takehara H, Yakabe S, Kameoka K. Laparoscopic percutaneous extra- peritoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions. J Pediatr Surg 2006;41(12):1999–2003. DOI: 10.1016/j.jpedsurg.2006.08.032.
  22. Becmeur F, Philippe P, Lemandat-Schultz A, et al. A continuous series of 96 laparoscopic inguinal hernia repairs in children by a new technique. Surg Endosc 2004;18(12):1738–1741. DOI: 10.1007/s00464-004-9008-5.
  23. Giseke S, Glass M, Tapadar P, et al. A true laparoscopic herniotomy in children: evaluation of long-term outcome. J Laparoendosc Adv Surg Tech A 2010;20(2):191–194. DOI: 10.1089/lap.2009.0069.
  24. Wheeler AA, Matz ST, Schmidt S, et al. Laparoscopic inguinal hernia repair in children with transperitoneal division of the hernial sac and proximal purse string closure of peritoneum: our modified new approach. Eur J Pediatr Surg 2011;21(2):381–385. DOI: 10.1055/s-0031-1291181.
  25. Endo M, Watanabe T, Nakano M, et al. Laparoscopic completely extraperitoneal repair of inguinal hernia in children: a single-institute experience with 1,257 repairs compared with cut-down herniorrhaphy. Surg Endosc 2009;23(8):1706–1712. DOI: 10.1007/s00464-008-0300-7.
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