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Published in: Hernia 2/2013

01-04-2013 | Original Article

Laparoscopic repair of incarcerated inguinal hernia. A safe and effective procedure to adopt in children

Authors: C. Esposito, S. Turial, F. Alicchio, J. Enders, M. Castagnetti, K. Krause, A. Settimi, F. Schier

Published in: Hernia | Issue 2/2013

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Abstract

Background

The purpose of our retrospective study was to describe the efficacy and the advantages of laparoscopic approach to treat incarcerated inguinal hernia (IIH) in pediatric patients.

Methods

In a 2-year period, 601 children underwent a laparoscopic inguinal hernia repair, 46 (7.6 %) of them presented an IIH. Our study will be focused on these 46 patients: 30 boys and 16 girls (age range 1 month–8 years).

Results

Twenty-one/46 hernias (45.6 %) were reduced preoperatively and then operated laparoscopically (RH), 25/46 (54.4 %) were irreducible and they were operated directly in laparoscopy (IRH). We have no conversions in our series. The length of surgery in RH group was in median 23 min and in IRH group was in median 30 min. Hospital stay was variable between 6 h and 3 days (median 36 h).With a minimum follow-up of 14 months, we had 2/46 recurrences (4.3 %).

Conclusion

The laparoscopic approach to IIH appears easy to perform from the technical point of view. The 3 main advantages of laparoscopic approach are that all edematous tissue are surgically bypassed and the cord structures are not touched; the reduction is performed under direct visual control, and above all, an inspection of the incarcerated organ is performed at the end of procedure.
Literature
1.
go back to reference Nah SA, Giacomello L, Eaton S (2011) Surgical repair of incarcerated inguinal hernia in children: laparoscopic or open? Eur J Pediatr Surg 21:8–11PubMedCrossRef Nah SA, Giacomello L, Eaton S (2011) Surgical repair of incarcerated inguinal hernia in children: laparoscopic or open? Eur J Pediatr Surg 21:8–11PubMedCrossRef
2.
go back to reference Rescorla FJ, Grosfeld JL (1984) Inguinal hernia repair in the perinatal period and early infancy: clinical considerations. J Pediatr Surg 19:832–837PubMedCrossRef Rescorla FJ, Grosfeld JL (1984) Inguinal hernia repair in the perinatal period and early infancy: clinical considerations. J Pediatr Surg 19:832–837PubMedCrossRef
3.
go back to reference Lau ST, Lee YH, Caty MG (2007) Current management of hernias and hydroceles. Semin Pediat Surg 16:50–57CrossRef Lau ST, Lee YH, Caty MG (2007) Current management of hernias and hydroceles. Semin Pediat Surg 16:50–57CrossRef
4.
go back to reference Baird R, Gholoum S, Laberge JM, Puligandla P (2011) Prematurity, not age at operation or incarceration, impacts complication rates of inguinal hernia repair. J Pediatr Surg 46:908–911PubMedCrossRef Baird R, Gholoum S, Laberge JM, Puligandla P (2011) Prematurity, not age at operation or incarceration, impacts complication rates of inguinal hernia repair. J Pediatr Surg 46:908–911PubMedCrossRef
5.
go back to reference Gholoum S, Baird R, Laberge JM, Puligandla P (2010) Incarceration rates in pediatric inguinal hernia: do not trust the coding. J Pediatr Surg 45:1007–1711PubMedCrossRef Gholoum S, Baird R, Laberge JM, Puligandla P (2010) Incarceration rates in pediatric inguinal hernia: do not trust the coding. J Pediatr Surg 45:1007–1711PubMedCrossRef
6.
go back to reference Nagraj S, Sinha S, Johnson P (2006) The incidence of complications following primary inguinal herniotomy in babies weighing 5 kg or less. Pediatr Surg Int 22:500–502PubMedCrossRef Nagraj S, Sinha S, Johnson P (2006) The incidence of complications following primary inguinal herniotomy in babies weighing 5 kg or less. Pediatr Surg Int 22:500–502PubMedCrossRef
7.
go back to reference Zamakhshary M, To T, Langer JC (2008) Risk of incarceration of inguinal hernia among infants and young children awaiting elective surgery. Can Med Assoc J 179:1001–1005CrossRef Zamakhshary M, To T, Langer JC (2008) Risk of incarceration of inguinal hernia among infants and young children awaiting elective surgery. Can Med Assoc J 179:1001–1005CrossRef
8.
go back to reference Stylianos S, Jacir NN, Harris BH (1993) Incarceration of inguinal hernia in infants prior to elective repair. J Pediatr Surg 28:582–583PubMedCrossRef Stylianos S, Jacir NN, Harris BH (1993) Incarceration of inguinal hernia in infants prior to elective repair. J Pediatr Surg 28:582–583PubMedCrossRef
9.
go back to reference Chen LE, Zamakhshary M, Langer JC (2009) Impact of wait time on outcome for inguinal hernia repair in infants. Pediatr Surg Int 25:223–227PubMedCrossRef Chen LE, Zamakhshary M, Langer JC (2009) Impact of wait time on outcome for inguinal hernia repair in infants. Pediatr Surg Int 25:223–227PubMedCrossRef
10.
go back to reference Misra D, Hewitt G, Potts SR (1994) Inguinal herniotomy in young infants, with emphasis on premature neonates. J Pediatr Surg 29:1496–1498PubMedCrossRef Misra D, Hewitt G, Potts SR (1994) Inguinal herniotomy in young infants, with emphasis on premature neonates. J Pediatr Surg 29:1496–1498PubMedCrossRef
11.
go back to reference Schier F (2000) Laparoscopic surgery of inguinal hernias in children: initial experience. J Pediatr Surg 35:1331–1335PubMedCrossRef Schier F (2000) Laparoscopic surgery of inguinal hernias in children: initial experience. J Pediatr Surg 35:1331–1335PubMedCrossRef
12.
go back to reference Esposito C, Montupet P (1998) Laparoscopic treatment of recurrent inguinal hernia in children. Pediatr Surg Int 14:182–184PubMedCrossRef Esposito C, Montupet P (1998) Laparoscopic treatment of recurrent inguinal hernia in children. Pediatr Surg Int 14:182–184PubMedCrossRef
13.
go back to reference Schier F (2000) Direct inguinal hernias in children, the laparoscopic aspect. Pediatr Surg Int 16:562–564PubMedCrossRef Schier F (2000) Direct inguinal hernias in children, the laparoscopic aspect. Pediatr Surg Int 16:562–564PubMedCrossRef
14.
go back to reference Kaya M, Hukstedt T, Schier F (2006) Laparoscopic approach to incarcerated inguinal hernia in children. J Pediatr Surg 41:567–569PubMedCrossRef Kaya M, Hukstedt T, Schier F (2006) Laparoscopic approach to incarcerated inguinal hernia in children. J Pediatr Surg 41:567–569PubMedCrossRef
15.
go back to reference Rescorla FJ, West KW (1997) The other side of paediatric hernias: the role of laparoscopy. Am Surg 63:690–693PubMed Rescorla FJ, West KW (1997) The other side of paediatric hernias: the role of laparoscopy. Am Surg 63:690–693PubMed
16.
go back to reference De Caluwe D, Cherti B, Puri P (2003) Childhood femoral hernia: a commonly misdiagnosed condition. Pediatr Surg Int 19:608–609PubMedCrossRef De Caluwe D, Cherti B, Puri P (2003) Childhood femoral hernia: a commonly misdiagnosed condition. Pediatr Surg Int 19:608–609PubMedCrossRef
17.
go back to reference Perlstein J, Du Bois JJ (2000) The role of laparoscopy in the management of suspected recurrent paediatric hernias. J Pediatr Surg 35:1205–1208PubMedCrossRef Perlstein J, Du Bois JJ (2000) The role of laparoscopy in the management of suspected recurrent paediatric hernias. J Pediatr Surg 35:1205–1208PubMedCrossRef
18.
go back to reference Schier F (2006) Laparoscopic inguinal hernia repair—a prospective personal series of 542 children. J Pediatr Surg 41:1081–1084PubMedCrossRef Schier F (2006) Laparoscopic inguinal hernia repair—a prospective personal series of 542 children. J Pediatr Surg 41:1081–1084PubMedCrossRef
19.
go back to reference Schier F, Montupet P, Esposito C (2002) Laparoscopic inguinal herniorrhaphy in children: a 3 centre experience with 933 repairs. J Pediatr Surg 37:395–397PubMedCrossRef Schier F, Montupet P, Esposito C (2002) Laparoscopic inguinal herniorrhaphy in children: a 3 centre experience with 933 repairs. J Pediatr Surg 37:395–397PubMedCrossRef
20.
go back to reference Parelkar SV, Oak S, Gupta R, Sanghvi B, Shimoga PH, Kaltari D, Prakash A, Shekhar R, Gupta A, Bachani ML (2010) Laparoscopic inguinal hernia repair in the pediatric age group–experience with 437 children. J Pediatr Surg 45:789–792PubMedCrossRef Parelkar SV, Oak S, Gupta R, Sanghvi B, Shimoga PH, Kaltari D, Prakash A, Shekhar R, Gupta A, Bachani ML (2010) Laparoscopic inguinal hernia repair in the pediatric age group–experience with 437 children. J Pediatr Surg 45:789–792PubMedCrossRef
21.
go back to reference Montupet P, Esposito C (2011) Fifteen years experience in laparoscopic inguinal hernia repair in pediatric patients. Results and considerations on a debated procedure. Surg Endosc 25:450–453PubMedCrossRef Montupet P, Esposito C (2011) Fifteen years experience in laparoscopic inguinal hernia repair in pediatric patients. Results and considerations on a debated procedure. Surg Endosc 25:450–453PubMedCrossRef
22.
go back to reference Esposito C, Montinaro L, Alicchio F (2010) Laparoscopic treatment of inguinal hernia in the first year of life. J Laparoendosc Adv Surg Technol A 20:473–476CrossRef Esposito C, Montinaro L, Alicchio F (2010) Laparoscopic treatment of inguinal hernia in the first year of life. J Laparoendosc Adv Surg Technol A 20:473–476CrossRef
23.
go back to reference Esposito C, Montinaro L, Alicchio F (2009) Technical standardization of laparoscopic herniorraphy in pediatric patients. World J Surg 33:1846–1850PubMedCrossRef Esposito C, Montinaro L, Alicchio F (2009) Technical standardization of laparoscopic herniorraphy in pediatric patients. World J Surg 33:1846–1850PubMedCrossRef
24.
go back to reference Jones PF, Towns GM (1983) An abdominal extraperitoneal approach for the incarcerated inguinal hernia of infancy. Br J Surg 70:719–720PubMedCrossRef Jones PF, Towns GM (1983) An abdominal extraperitoneal approach for the incarcerated inguinal hernia of infancy. Br J Surg 70:719–720PubMedCrossRef
Metadata
Title
Laparoscopic repair of incarcerated inguinal hernia. A safe and effective procedure to adopt in children
Authors
C. Esposito
S. Turial
F. Alicchio
J. Enders
M. Castagnetti
K. Krause
A. Settimi
F. Schier
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
Hernia / Issue 2/2013
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-012-0948-8

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