Laparoscopic approach to incarcerated inguinal hernia in children

Purpose: The purpose of this study was to describe the laparoscopic approach to incarcerated inguinal hernia in children. Methods: After unsuccessful manual reduction, 29 patients (aged 3 weeks to 7 years; median, 10 weeks; 44 boys, 15 girls) with incarcerated inguirial hernia underwent immediate laparoscopy. The hernial content was reduced in a combined technique of external manual pressure and internal pulling by forceps. The bowel was inspected, and the hernia was repaired. Results: In all patient, the procedure was successful. No conversion to the open approach was required. Immediate laparoscopic hermorrhaphy in the same session was added. No complications occurred. Conclusions: Laparoscopy allowed for simultaneous reduction under direct visual control, inspection of the incarcerated organ, and definitive repair of the hernia. Technically, it appears easier than the conventional approach because of the internal inguinal ring being widened by intraabdominal carbon dioxide insufflation. The hospital stay is shorter. (c) 2006 Elsevier Inc. All righs reserved.