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Laparoscopic Repair of Inguinal Hernia in Children. An Endless Debate - Abstract

Khalid K. Sabet Al Ali, Mohamed E Hassan


 

Abstract

Introduction

Inguinal hernia repair is one of the most frequently performed pediatric surgical operations. Unresolved debate still exists regarding the benefit of using laparoscopy over openrepair. The aim of this study was to retrospectively analyze the files of all children who underwent inguinal herniotomy, open and laparoscopic, in a single pediatric surgery center in UAE, to compare both procedures and to conclude which procedure is more feasible.

Patients and method

The study was a retrospective study conducted in the Pediatric Surgery Department, Al Qassemi Hospital, Sharjah, UAE between January 2010 and December 2012. File review was done by an independent reviewer for all cases who had inguinal herniotomy during this period whether open orlaparoscopic.

Results

A total of 320 cases of inguinal herniotomy, 120 laparoscopically (LH) versus 200 open (OH). Mean age for LH was 54 month versus 32 months for OH. In LH 12.5% wereoperated bilaterally (13 male, 2 female) versus 9% in OH (18 male). Mean operative time in LH (unilateral only) was 24 minutes versus 19 minutes in open group.  In LH there was one case (0.8%) of internal ring hematoma due to injury to inferior epigastric vessels where bleeding stopped spontaneously; there were no intraoperative complications in the open group. Follow up period ranged from 8 months to 2 years.  There was no recurrence in the OH group, however the LH had one recurrent case (0.8%) which was a sliding hernia of urinary bladder. There was one case of ascending testis (0.5%) in the open group.

Conclusion

Our preliminary results for laparoscopic inguinal herniotomy in children above one year show comparable results to open technique in the short term follow up. Laparoscopic technique offers visualization of the opposite side. We will conduct a prospective study with longer follow up and younger age group to have more accurate validated data.

Keywords:  laparoscopy, inguinal hernia, children


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