Laparoscopic surgery of inguinal hernias in children - Initial experience

Purpose: The aim of this study was to document the authors' experience with laparoscopy in the treatment of inguinal hernia in girls and boys. Methods: The internal inguinal ring was closed with 1 or 2 stitches of 4-0 monofilamentous material. Two 2-mm needle holders were inserted through the inferolateral abdominal wall. The laparoscope was advanced through the umbilicus. A total of 129 children underwent surgery. Results: Once the technique of intracorporeal suturing is mastered, the procedure is straightforward, requiring 22 minutes for bilateral and 16 minutes for unilateral hernias. Age and size are not facto rs because of the magnifying effect of the laparoscope. In almost half our patients, the preoperative diagnosis could not be matched unequivocally with the intraoperative findings. There was 1 recurrence of hernia in a boy. No serious complications and no hydroceles occurred. Five direct hernias were found in this group (5%), Conclusions: The technique is easy for experienced laparoscopists. Bilaterality is of no concern. Cosmesis is superb. For recurrences, the technique is preferable to the open technique. J Pediatr Surg 35:1331-1335. Copyright (C) 2000 by W.B. Saunders Company.