TRANSPERITONEAL CLOSURE OF THE INTERNAL RING IN INCARCERATED INFANTILE INGUINAL-HERNIAS

Over a a-year period, 14 infants with a total of 16 inguinal hernias ( IH) underwent transperitoneal closure of the internal ring (TPIR). Thi s was performed through a minilaparotomy, using a purse-string suture placed around the internal ring from within, A difficult inguinal diss ection of an edematous and friable spermatic cord was avoided. TPIR wa s performed for incarceration in 13 of the infants and for recurrence of the hernia within 24 hours of herniotomy in one. There were no intr aoperative problems, and during follow-up there was no evidence of tes ticular atrophy or recurrence of the hernia. This suggests that TPIR i s a reliable and safe operation in babies for whom the alternative ing uinal approach would be difficult. These situations include hernias th at are irreducible and early recurrence in which dissection of the cor d would risk damage to the vas deferens or testicular vessels. Copyrig ht (C) 1995 by W.B. Saunders Company