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Button-Hole Inguinal Hernia Repair- A Single Surgeon’s 13 Years Experience - Abstract

Katherine M Burnand, Alok Godse, Azad B Mathur


Purpose: Button-hole herniotomy (BHH) is a novel approach to repair paediatric inguinal hernias which involves only a very small incision in the external oblique muscle. We reviewed our 13 year experience of BHH.

Patients and Methods: Children who underwent BHH repair at our unit between 1996 and 2009 were included in the study. Hospital notes were reviewed retrospectively and presenting symptoms, hernioscopy, simultaneous procedures including repair of contralateral side, duration of operation, postoperative complications and follow up were recorded.

Results: One hundred seventy-six patients (46 girls, 130 boys) had a BHH; the mean age at operation was 5.72 (range 1.01–15.18) years. There were 63% right, 31% left, and 5% bilateral. Hernioscopy was performed in 47 patients. A patent contralateral internal ring was seen in 6 patients (13.0%). Mean follow up was 3.5 (range 1-12) months. There were 2 recurrences (1.1%) and the contralateral side had to be repaired in 3 patients who had not had hernioscopy (1.7%).

Conclusion: BHH repair is safe and effective in children. The technique enables drainage of hydrocele and hernioscopy at the same time. The complication rate, including recurrence, is comparable to other open and laparoscopic techniques.

Keywords: button-hole herniotomy, hernioscopy, recurrence


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