Laparoscopic treatment of congenital inguinal hernia in children

Purpose: The authors report their experience in the laparoscopic treatment of congenital inguinal hernia in children. Methods: Between September 1994 and September 1995, 45 boys between 8 month s and 13 years of age (mean, 4 years) were treated laparoscopically for hyd roceles, spermatic cord cysts, or hernias. Twenty-six (57.8%) boys showed a right inguinal hernia, 17 (37.8%) a left hernia, and two cases (4.4%) pres ented the clinical data of a bilateral pathology. The approach used for sma ll hernias was the placement of purse-string suture around the internal ori fice of the inguinal canal (28 cases). As to hernias exceeding 4 to 5 mm in diameter, the external hemicircumference of the neck was opened to bring t he conjoined tendon closer to the crural arch with a non resorbable suture (17 cases). There was never need to use a prosthesis. Results: Surgery lasted from 15 to 45 minutes with the duration decreasing with experience. There were no intra- or postsurgical complications. Two pa tients (4.4%) experienced a recurrent inguinal hernia, which was successful ly operated on again with laparoscopy, Conclusion: The early results of these authors suggest that laparoscopic su rgery is a feasible and safe technique for the treatment of patent peritone al vaginal canal (PVC) and inguinal hernia in children. Copyright (C) 1999 by W.B. Saunders Company.