Comparison of laparoscopic percutaneous internal ring suturing method and open inguinal hernia repair in children under 3 months of age
Ergun Ergün1, Beytullah Yağız2, Yusuf Alper Kara3, Aslı Nur Abay3, Özlem Balcı3, Sibel Eryılmaz3, İsmet Faruk Özgüner3, Ayşe Karaman3, İbrahim Karaman3
1Division of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
2Division of Pediatric Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
3Clinic of Pediatric Surgery, Dr. Sami Ulus Research and Training Hospital, Ankara, Turkey
Objective: Laparoscopic inguinal hernia repair in younger infants has not been completely accepted worldwide. The aim of this study was to evaluate the safety and feasiblity of laparoscopic percutaneous internal ring suturing method in children aged younger than 3 months and compare the recurrence and complication rates with open repair; which may still be mentioned as the gold standard procedure.
Material and Methods: A total of 387 children underwent inguinal hernia repair in the clinic between 2016 and 2019. One hundred and forty of them were under 3 months old and divided into two groups; children who underwent laparoscopic percutaneous internal ring suturing (Group 1) and open surgery (Group 2). Selection of the surgical method was regardless of weight, sex or any patient characteristics other than surgeon’s choice. Operation durations, complications and recurrences were compared between the two groups.
Results: A total of 140 patients underwent surgery due to inguinal hernia. Group 1 included 85 and Group 2 included 55 children. There were two recurrences in each group (p> 0.05). Operative durations were shorter in Group 1 for both; unilateral and bilateral repairs (p< 0.0001). There were no intraoperative complications in any group. There was one major postoperative complication in Group 2: iatrogenic undescended testis, and none was observed in Group 1. In the laparoscopic group, 47% of the children who were diagnosed to have unilateral hernia were revealed to have bilateral inguinal hernias (n= 31).
Conclusion: Laparoscopic percutaneous internal ring suturing method seems favourable in terms of operative time. It also has the advantage of detecting contralateral patent processus vaginalis or asymptomatic contralateral inguinal hernia.
Keywords: Infant, inguinal hernia, laparoscopy
Cite this article as: Ergün E, Yağız B, Kara YA, Abay AN, Balcı Ö, Eryılmaz S, et al. Comparison of laparoscopic percutaneous internal ring suturing method and open inguinal hernia repair in children under 3 months of age. Turk J Surg 2021; 37 (3): 215-221.
The ethical approval for this study was obtained from SUAM Committee of Medical Residency Training (Decision No: 2020/01-2, Date: 22.01.2020).
Concept - All of authors; Design - E.E., B.Y., Y.A.K.; Supervision - E.E., B.Y., Y.A.K., İ.K., A.N.A.; Data Collection and/or Processing - All of authors; Analysis and/or Interpratation - Y.A.K.; A.N.A., Ö.B.; S.E.; A.K. Literature Review - E.E., B.Y., Y.A.K., A.N.A., S.E., Ö.B.; Writing Manuscript - Ö.B., S.E., İF.Ö., A.K., İ.K.; Critical Reviews - All of authors.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.