Laparoscopic Hernia Repair in Children: A Study of Various Techniques and Related Complications
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 9
Abstract
Laparoscopic inguinal hernia repair has increasingly been used in paediatrics but the outcome is still not clearly understood. New techniques keep on coming for the repair of patent process vaginalis with new outcomes. This study is designed to assess the feasibility, advantages and disadvantages of laparoscopic hernia repair in children of age <18 yrs, to study different techniques of laparoscopic hernia repair, technical steps to achieve an appropriate repair, the recurrence rates and complications of the procedure in our setup. Prospective and retrospective study of laparoscopic inguinal hernia repair performed in dept of paediatric surgery, NSCB Medical College, Jabalpur, M.P. during July 2009 to July 2012 was done. A total of 79 cases with extracorporeal endosuturing technique, intracorporeal and with SILS technique. Author has also introduced nonsuture technique (tackers) for hernia repair. Various outcomes were studied such as contralateral patency, operative duration, hospital stay, recurrence rate, complications and postoperative results. In this study 79 children underwent inguinal hernia repair laparoscopically of which 53(67.1%) were male and 26(32.9%) females; 73(92.4%) unilateral and 6(7.6%) bilateral. In 31(39.24%) intracorporeal and 34(43.04%) extracorporeal suturing of hernial sacs was done and in rest 14 cases(17.12%) we used tackers to repair the internal ring. 11 cases(13.92%) were done by single incision laparoscopic surgery(SILS). Sac excision was done in 53 cases (67.1%) and ligation of sac without excision in rest 26(32.9%) cases. Contralateral patent processusvaginalis was found in 17.72% (14) cases intraoperatively in our study of which 8 cases(57.14%) were without manifest hernia contralaterally and all these cases were repaired intraoperatively. Mean Operating duration was 28min and 28.09min for unilateral and for bilateral cases. All patients were discharged in 1 day with no significant intraoperative or postoperative complications. Recurrence was seen in only 2(2.53%) case which was due complete resorption of absorbable suture in cases were sac was not excised in complete hernia. Hydrocoele was found in 2(2.53%) cases.
Authors and Affiliations
Dr. Pooja Tiwari
Keywords
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