American Journal of Clinical and Experimental Medicine
Volume 5, Issue 5, September 2017, Pages: 181-185
Received: Aug. 18, 2017;
Accepted: Sep. 19, 2017;
Published: Sep. 20, 2017
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Deepak Verma, Department of Surgery, Dr. Sampurnanand Medical College, Jodhpur, India
Deva Ram, Department of Surgery, Dr. Sampurnanand Medical College, Jodhpur, India
Mukteshwar Gupta, Department of Surgery, Dr. Sampurnanand Medical College, Jodhpur, India
Nemi Chand, Department of Surgery, Dr. Sampurnanand Medical College, Jodhpur, India
Pediatric patients presenting as inguinal hernia or congenital hydrocele is common ailment encountered in surgical practice and herniotomy is a very common surgical procedure performed. Open procedure is gradually being replaced by laparoscopic approach because of the distinct advantages of early recovery, short stay and better cosmetic results. 150 pediatric patients of inguinal hernia or congenital hydrocele were subject of this study. These patients were subjected to laparoscopic herniotomy performed at the neck of the sac and proximal part of peritoneum was closed with non-absorbable polypropyelene suture with aspiration of scrotal sac, if required. Average age of patients was 6.5 year with 93.35% male. 70.6% had inguinal hernia and 29.4% had congenital hydrocele). 68% patients had right sided and 10.6% clinically bilateral lesion. Operating time was 25 minutes in unilateral and 34.8 minutes in bilateral procedure. Postoperative stay was 1.06 days. No intraoperative complication was noted. Recurrence rate was 1.33% and conversion rate was 0.66%. Laparoscopic herniotomy is safe, well tolerated and effective procedure with early recovery, short operating time, less postoperative pain, free of complication, shorter post-operative hospital stay and very low recurrence. It can detect contralateral patent processus vaginalis and bilateral closure of it can be done through same approach.
Laparoscopic Herniotomy – A Single Centre Study of 150 Cases, American Journal of Clinical and Experimental Medicine.
Vol. 5, No. 5,
2017, pp. 181-185.
Singer C. Galen on Anatomical procedures. London 1956, Oxford University Press – Nyhus HM, Harkin HN. Hernia, Philadelphia, 1964. JB Lippincott.
Miltenburg DM, Nuchtern JG, Jaksic T, Kozinetiz C, Brandt ML. Laparoscopic evaluation of the pediatric hernia; a meta-analysis. J Pediatr Surg 1998; 33 (6): 874-9.
Van Wessem KJ, Simons MP, Plaisier PW, Lange JF. The ethiology of indirect inguinal hernias: congenital and/or acquired? Hernia 2003; 7 (2): 76-9.
Rowe MI, Copelsom LW, Clatworthy HW. The patent processus vaginalis and inguinal hernia. J Pediatr Surg 1969; 4: 102-7.
Feehan BP, Fromm DS, Laparoscopic Pediatric Inguinal Hernia Repair: Overview of “True Herniotomy” Technique and Review of Current Evidence. S. D. Med, 2017: 70 (5): 217-223.
Ferguson AH, Oblique inguinal hernia: a typical operation for its radical cure. JAMA 1899; 33: 6.
Potts WJ, Riker WL, Lewis JE. The treatment of inguinal hernia in infants and children. Ann Surg 1950; 132: 566.
Raveenthiran V, Agarwal P. Choice of Repairing Inguinal Hernia in Children: Open versus Laparoscopy. Indian J Pediatr, 2017; 84 (7): 555-563.
Tsai YC, Wu CC, Yang SSD. Open versus minilaparoscopic herniorraphy for children: a prospective comparative trial with midterm follow-up evaluation. Surg Endosc. 2010; 24 (1): 21-4.
Grimsby GM, Keays MA, Villanuava C, Bush NC, Shodgrass WT, Gargolid PC et al. Non-absorbable sutures are associated with lower recurrence rates in laparoscopic percutaneous inguinal hernia ligation. J Paediatr Urol, 2015; 11 (5) 275 e 1-4.
Saranga Bharathi, Arora M, Baskaran V. Pediatric inguinal hernia: laparoscopic versus open surgery. JSLS 2008; 12: 277-81.
Hassan ME, Mustafawi AR. Laparoscopic flip-flap technique versus conventional inguinal hernia repair in children. JSLS 2007; 11: 90-3.
Chinnaswamy P, Malladi V, Jani KV, Parthasarthi R, Shetty RA, Kovalakat AJ et al. Laparoscopic hernia repair in children. JSLS 2005; 9 (4): 393-8.
Abdul Rahman A. Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis. Pediatr Surg Int 2011; 27 (6): 605-12.
Liu C, Chin T, Jas SE, Wei C. Intraoperative laparoscopic diagnosis of contralateral patent processus vaginalis in children with unilateral inguinal hernia. Br J Surg 1995; 82: 106-8.
Koivusalo AI, Korpela R, Wirtavouri K, Piiparinen S, Rintala RJ, Pakarinen MP. A single-blinded randomized comparison of laparoscopic versus open hernia repair in children. Pediatrics 2009; 123: 332-7.
Chan KL, Hui WC, Tam PK. Prospective randomized single-center, single-blinded comparison of laparoscopic vs open repair of pediatric inguinal hernia. Surg Endosc 2005; 19: 927-32.
Ozgediz D, Roayaie K, Lee H, Nohuhara KK, Farmer DL, Bratton B et al. Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: report of a new technique and early results. Surg Endosc 2007; 21 (8): 1327-31.
Endo M, Watanbe T, Nakano M, Yoshida F, Ukiyama E, Laparoscopic completely extraperitoneal repair of inguinal hernia in children: a single institute experience with 1,257 repairs compared with cut-down herniorraphy. Surg Endosc 2009; 23 (8): 1706-12.
Yang C, Zhang H, Pu J, Mei H. Laparoscopic vs open herniorraphy in the management of pediatric inguinal hernia; a systemic review and meta-analysis. J Pediatr Surg 2011; 46 (9) 1824-34.
Chen MK, Schropp KP, Lobe TE. Complications of minimal-access surgery in children. J Pediatr Surg 1996; 31: 1161-5.
Ylidz A, Celebi S, Akin M, Karadag CA, Sever N., Erginel B et al. Laparoscopic hernioraphy: a better approach for recurrent hernia in boys. Paediatr Surg Int, 2012: 28 (5): 449-53.
Nah SA, Giacomelo L, Eaton S, De Coppi P, Curry JI, Drake DP et al. Surgical repair of incarcerated inguinal hernia in children: laparoscopic or open. Eur J Pediatr Surg: 2011; 21 (5): 8-11.
Zhu LL, Yu WJ, Liu JB, Huang X, Lv ZB. Comparison of laparoscopic hernia repair and open herniotomy in children: a retrospective cohort study. Hernia, 2017; 221 (3): 417-423.
Feng S, Zhao L, Liao Z, Chen X. Open versus laparoscopic inguinal herniotomy in children: A systematic review and meta-analysis focusing on post-operative complications. Surg Laparosc Endosc Percutan Tech. 2015; 625 (4): 275-80.
Shalaby R, Ibrahem R, Shahin M, Yehya A, Razek MA, Alsayaad A et al. Laparoscopic hernia repair versus open herniotomy in children: a controlled randomized study. Minim Invasive Surg. 2012; 2012: 484135, doi: 10.1155/2012 /484135Epub 2012 Dec27.
Glaskee S, Glass M, Tapador P, Matthussens L, Phillipe P. A true laparoscopy herniotomy in children: evaluation of long term result. J Laparoendos Adv Surg Tech A. 2010; 20 (2): 191-4 doi: 10,1089/Lap.2009.0069.