World Journal of Laparoscopic Surgery

Register      Login

VOLUME 17 , ISSUE 1 ( January-April, 2024 ) > List of Articles

Original Article

Laparoscopic Inguinal Hernia Repair for Children is the Final Frontier: Experience from a Tertiary Care Center

Jyotirmaya Nayak, Ashish Kumar Behera, Rupashree Sahoo

Keywords : Herniotomy, Inguinal hernia, Laparoscopic

Citation Information : Nayak J, Behera AK, Sahoo R. Laparoscopic Inguinal Hernia Repair for Children is the Final Frontier: Experience from a Tertiary Care Center. World J Lap Surg 2024; 17 (1):5-8.

DOI: 10.5005/jp-journals-10033-1600

License: CC BY-NC 4.0

Published Online: 14-02-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: Pregnancy-induced hypertension (PIH) has been conventionally managed by open surgery and herniotomy which is the standard of care. But in the era of minimal access surgery, laparoscopic surgery for pediatric inguinal hernia has emerged as an alternative and is being routinely performed at many centers. Laparoscopic herniotomy is a safe and feasible option for pediatric inguinal hernia in present times. It has shown results similar to well-performed conventional herniotomy procedure with respect to marked reduction in operative time, and postoperative complications, postoperative pain, postoperative hospital stay, low rate of recurrence, no testicular atrophy, no iatrogenic ascent of testis, no postoperative hydrocele formation and excellent cosmesis. It provides a superior tool to diagnose contralateral patency of processus vaginalis (CPPV) or rare hernias that can be managed in the same session with minimal dissection, lesser postoperative complications, and better cosmesis thus favoring its wider adoption among surgeons globally in management of pediatric inguinal hernia. Method: Data for all elective cases of PIH who underwent initial laparoscopic herniotomy repair in routine operation theater at our tertiary care center, during the period from 1st March 2010 to 1st March 2023 have been collected. Results: A total of 53 laparoscopic inguinal herniotomies were performed on 50 patients. The median age of patients at the date of operation was 6.2 years. Of all patients, 47 cases were unilateral and 3 were bilateral inguinal hernias (IHs). Conclusion: Laparoscopic inguinal herniotomy is a technically easier and safer technique than conventional open methods as there is no need for dissection of vas deferens and vessels. Laparoscopic herniotomy allows for the excellent visualization of cord structures and their proper safeguarding during the procedure. Simultaneous identification of CPPV in cases of unilateral IH and its repair reduces the risk of metachronous hernia as well. Less postoperative pain, early recovery, and better cosmesis make laparoscopic surgery the final frontier in the management of PIH, thus cementing its role as a viable and probably a better alternative to conventional repair.

  1. Van Batavia JP, Tong C, Chu DI, et al. Laparoscopic inguinal hernia repair by modified peritoneal leaflet closure: Description and initial results in children. J Pediatr Urol 2018;14(3):272.e1–272.e6. DOI: 10.1016/j.jpurol.2018.02.015.
  2. Esposito C, Escolino M, Turrà F, et al. Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in Laparoscopic Era. Semin Pediatr Surg 2016;25(4):232–240. DOI: 10.1053/j.sempedsurg.2016.05.006.
  3. Ein SH, Njere I, Ein A. Six thousand three hundred sixty-one pediatric inguinal hernias: A 35-year review. J Pediatr Surg 2006;41(5):980–986. DOI: 10.1016/j.jpedsurg.2006.01.020.
  4. Shcheben'kov MV. The advantages of laparoscopic inguinal herniorrhaphy in children. Vestn Khir Im II Grek 1997;156(1):94–96. PMID: 9163206.
  5. Palanivelu C. Laparoscopic pediatric hernia repair. In: Operative Manual of Laparoscopic Hernia Surgery. Coimbatore, India: Gem Foundation; 2004; pp. 195–205.
  6. Schier F. Laparoscopic surgery of inguinal hernias in children—Initial experience. J Pediatr Surg 2000;35(9):1331–1335. DOI: 10.1053/jpsu.2000.9326.
  7. Schier F. Direct inguinal hernia in children: The laparoscopic aspect. J Pediatr Surg 2000;16(8):562–564. DOI: 10.1007/s003830000431.
  8. Davies DA, Rideout DA, Clarke SA. The International Pediatric Endosurgery Group Evidence-based guideline on minimal access approaches to the operative management of inguinal hernia in children. J laparoendosc Adv Surg Tech A 2020;30(2):221–227. DOI: 10.1089/lap.2016.0453.
  9. Alzahem A. Laparoscopic versus open inguinal herniotomy in infants and children: A meta-analysis. Pediatr Surg Int 2011;27(6):605–612. DOI: 10.1007/s00383-010-2840-x.
  10. Mahmood B, Christoffersen M, Miserez M, et al. Laparoscopic or open paediatric inguinal hernia repair—A systematic review. Dan Med J 2020;67:A12190725. PMID: 32734885.
  11. 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.
  12. Arregui ME, Navarrete J, Davis CJ, et al. Laparoscopic inguinal herniorrhaphy—Techniques and controversies. Surg Clin North Am 1993;73(3):513–527. DOI: 10.1016/s0039-6109(16)46034-2.
  13. Esposito C, Montupet P. Laparoscopic treatment of recurrent inguinal hernia in children. Pediatr Surg Int 1998;14(3):182–184. DOI: 10.1007/s003830050481.
  14. 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.
  15. Wheeler AA, Matz ST, Schmidt S, et al. Laparoscopic inguinal hernia repair in children with transperitoneal division of the hernia sac and proximal purse string closure of peritoneum: Our modified new approach. Eur J Pediatr Surg 2011;21(6):381–385. DOI: 10.1055/s-0031-1291181.
  16. Miltenburg DM, Nuchtern JG, Jaksic T, et al. Laparoscopic evaluation of the pediatric inguinal hernia – A meta-analysis. J Pediatr Surg 1998;33(6):874–879. DOI:
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.