The authors report their experience with the laparoscopic treatment of recu
rrent inguinal hernia in children. Between April 1993 and January 1998, 225
boys aged 8 months to 14 years (mean 4.4 years) were treated laparoscopica
lly for a hydrocele, spermatic-cord cyst, or hernia. Ten boys had recurrent
inguinal hernias after conventional surgery, in one case bilateral. The te
chnique requires 3 trocars: a 0 degrees, 5-mm telescope inserted through th
e umbilicus and two 3-mm trocars placed 3-4 cm below the umbilicus on eithe
r side. Simple patency of the peritoneal vaginal duct (dpv) was found in ei
ght cases and a direct inguinal hernia in three. In cases with an open dpv,
we opened the external hemicircumference of the heck in order to bring the
conjoined tendon closer to the crural arch with a non-resorbable 4/0 sutur
e, and then placed a 3/0 resorbable pursestring suture around the peritoneu
m of the internal orifice of the inguinal canal. In direct inguinal hernias
the orifice was closed by placing 2-3 nonabsorbable 3/0 sutures between th
e two muscular sides of the hernial defect. There were no intra- or postsur
gical complications. All patients, at a maximum follow-up of 3 years showed
total recovery from the hernia. Our early results suggest that laparoscopi
c surgery is a feasible and safe technique for the treatment of recurrent i
nguinal hernia in children.