Original articleLaparoscopic inguinal hernia repair—a prospective personal series of 542 children
Section snippets
Materials and methods
A total of 712 inguinal hernias were repaired laparoscopically in 542 children (396 boys and 146 girls, aged 4 days to 14 years, median 1.6 years). In most of the cases, the initial diagnosis was established by a referring pediatrician and confirmed preoperatively by a hospital-based pediatric surgeon.
Postoperatively, the surgeon saw all children personally after 4 weeks. Additional follow-up was scheduled if a complication arouse such as a recurrence.
General endotracheal anesthesia was used.
Results
There was no procedure-specific complication. Only 3 hydroceles (0.7%) and 1 testicular atrophy (0.2%) occurred postoperatively. The testicular atrophy followed former incarceration. The anatomy was always obvious. The operating time from skin-to-skin ranged from 10 to 55 minutes (median 20 minutes). Most children went home the same day. Thirty-two percent of children stayed one night postoperatively because of prematurity, parenteral preference, cultural expectations, or geographical distance.
Discussion
With the laparoscopic approach, rare hernia forms such as direct or femoral hernias are easily identified. It has been shown that with open surgery, femoral hernias are diagnosed correctly in only 53%, and that the recurrence rate is 13% [10]. With laparoscopy, the correct diagnosis is straightforward [11]. This may explain why direct, femoral, and combined hernias were seen more frequently. Also, a negative diagnosis, or absent hernia, is more easily documented in the laparoscopic technique.
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