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Hernia
Published in: Hernia 4/2019

01-08-2019 | Original Article

Laparoscopic reoperation for pediatric recurrent inguinal hernia after previous laparoscopic repair

Authors: S. R. Lee, P. J. Park

Published in: Hernia | Issue 4/2019

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Abstract

Purpose

Recurrence is a concerning area in pediatric inguinal hernia repair. Various laparoscopic repair methods are available to treat recurrent pediatric inguinal hernia. We analyzed previous laparoscopic hernia repairs and report the outcomes of laparoscopic inguinal hernia reoperations in patients with recurrent inguinal hernia.

Methods

Fifty-one patients who presented for recurrent inguinal hernia after laparoscopic hernia repair from September 2012 to May 2017 were retrospectively evaluated. Previous laparoscopic procedures were analyzed with respect to sac removal (removal vs. leaving in place), suture material (absorbable vs. nonabsorbable), and high ligation method (purse string vs. multiple stitches). We removed the hernia sac from all patients and performed suture repair of the muscular arch of the internal inguinal ring using nonabsorbable material.

Results

All patients (38 male, 13 female) had indirect inguinal hernias. No conversion to open surgery occurred. Forty-three (84.3%) patients developed recurrence within 1 year after the previous operation [mean 8.7 ± 6.9 (range 3–33) months]. Twenty patients had concurrent hydroceles (39.2%); 16 were cord hydroceles and 4 were canal of Nuck hydroceles. In the previous operations, the hernia sac was not removed in 100% (51/51) of patients, absorbable suture material was used in 58.8% (30/51), and purse string high ligation was performed in 88.2% (45/51). No re-recurrence developed during a mean follow-up of 25.0 ± 12.6 (range 13–54) months.

Conclusion

Laparoscopic reoperation with hernia sac removal and suture repair of the muscular arch of the internal inguinal ring with nonabsorbable material is an effective operation with few recurrences and complications.
Literature
1.
Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13:343–403CrossRefPubMedPubMedCentral
2.
Bisgaard T, Bay-Nielsen M, Kehlet H (2008) Re-recurrence after operation for recurrent inguinal hernia. A nationwide 8-year follow-up study on the role of type of repair. Ann Surg 247:707–711CrossRefPubMed
3.
Kockerling F, Jacob D, Wiegank W, Hukauf M, Schug-Pass C, Kuthe A, Bittner R (2016) Endoscopic repair of primary versus recurrent male unilateral inguinal hernias: are there differences in the outcome? Surg Endosc 30:1146–1155CrossRefPubMed
4.
Kockerling F, Bittner R, Kuthe A, Stechemesser B, Lorenz R, Koch A, Reinpold W, Niebuhr H, Hukauf M, Schug-Pass C (2017) Laparo-endoscopic versus open recurrent inguinal hernia repair: should we follow the guidelines? Surg Endosc 31:3168–3185CrossRefPubMed
5.
Varcus F, Duta C, Dobrescu A, Lazar F, Papurica M, Tarta C (2016) Laparoscopic repair of inguinal hernia TEP versus TAPP. Chirurgia (Bucur) 111:308–312
6.
Abd-Alrazek M, Alsherbiny H, Mahfouz M, Alsamahy O, Shalaby R, Shams A, Elian A, Ashour Y (2017) Laparoscopic pediatric inguinal hernia repair: a controlled randomized study. J Pediatr Surg 52:1539–1544CrossRefPubMed
7.
Lee SR, Choi SB (2017) The efficacy of laparoscopic intracorporeal linear suture technique as a strategy for reducing recurrences in pediatric inguinal hernia. Hernia 21:425–433CrossRefPubMed
8.
Amano H, Tanaka Y, Kawashima H, Deie K, Fujiogi M, Suzuki K, Morita K, Iwanaka T, Uchida H (2017) Comparison of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) and open repair for pediatric inguinal hernia: a single-center retrospective cohort study of 2028 cases. Surg Endosc 31:4988–4995CrossRefPubMedPubMedCentral
9.
Koivusalo AI (2017) A review of the incidence, manifestation, predisposing factors, and management of recurrent pediatric inguinal hernia. Eur J Pediatr Surg 27:478–483CrossRefPubMed
10.
Shalaby R, Ismail M, Gouda S, Yehya AA, Gamaan I, Ibrahim R, Hassan S, Alazab A (2015) Laparoscopic management of recurrent inguinal hernia in childhood. J Pediatr Surg 50:1903–1908CrossRefPubMed
11.
Shehata SM, ElBatarny AM, Attia MA, El Attar AA, Shalaby AM (2015) Laparoscopic interrupted muscular arch repair in recurrent unilateral inguinal hernia among children. J Laparoendosc Adv Surg Tech A 25:675–680CrossRefPubMed
12.
Chan KL (2007) Laparoscopic repair of recurrent childhood inguinal hernias after open herniotomy. Hernia 11:37–40CrossRefPubMed
13.
14.
Steinau G, Treutner KH, Feeken G, Schumpelick V (1995) Recurrent inguinal hernias in infants and children. World J Surg 19:303–306CrossRefPubMed
15.
Lee SR (2018) Benefits of laparoscopic posterior wall suture repair in treating adolescent indirect inguinal hernias. Hernia 22:653–659CrossRefPubMed
16.
HerniaSurge G (2018) International guidelines for groin hernia management. Hernia 22:1–165CrossRef
17.
Chan KL, Chan HY, Tam PK (2007) Towards a near-zero recurrence rate in laparoscopic inguinal hernia repair for pediatric patients of all ages. J Pediatr Surg 42:1993–1997CrossRefPubMed
18.
Shehata SM, Attia MA, Attar AAE, Ebid AE, Shalaby MM, ElBatarny AM (2018) Algorithm of laparoscopic technique in pediatric inguinal hernia: results from experience of 10 years. J Laparoendosc Adv Surg Tech A 28:755–759CrossRefPubMed
19.
Chen Y, Wang F, Zhong H, Zhao J, Li Y, Shi Z (2017) A systematic review and meta-analysis concerning single-site laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia and hydrocele. Surg Endosc 31:4888–4901CrossRefPubMed
20.
21.
Garcia-Hernandez C, Carvajal-Figueroa L, Suarez-Gutierrez R, Landa-Juarez S (2012) Laparoscopic approach for inguinal hernia in children: resection without suture. J Pediatr Surg 47:2093–2095CrossRefPubMed
22.
Marte A, Sabatino MD, Borrelli M, Parmeggiani P (2009) Decreased recurrence rate in the laparoscopic herniorraphy in children: comparison between two techniques. J Laparoendosc Adv Surg Tech A 19:259–262CrossRefPubMed
23.
Ozgediz D, Roayaie K, Lee H, Nobuhara KK, Farmer DL, Bratton B, Harrison MR (2007) Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: report of a new technique and early results. Surg Endosc 21:1327–1331CrossRefPubMed
24.
Grimsby GM, Keays MA, Villanueva C, Bush NC, Snodgrass WT, Gargollo PC, Jacobs MA (2015) Non-absorbable sutures are associated with lower recurrence rates in laparoscopic percutaneous inguinal hernia ligation. J Pediatr Urol 11:275.e1–275.e4CrossRef
25.
Ein SH, Nasr A, Wales P, Gerstle T (2009) The very large recurrent postoperative scrotal hydrocele after pediatric inguinal hernia repair: a rare problem. Pediatr Surg Int 25:239–241CrossRefPubMed
26.
Tsai YC, Wu CC, Yang SS (2007) Minilaparoscopic herniorrhaphy with hernia sac transection in children and young adults: a preliminary report. Surg Endosc 21:1623–1625CrossRefPubMed
27.
Chowbey PK, Pithawala M, Khullar R, Sharma A, Soni V, Baijal M (2006) Complications in groin hernia surgery and the way out. J Minim Access Surg 2:174–177CrossRefPubMedPubMedCentral
28.
Bouchot O, Branchereau J, Perrouin-Verbe MA (2018) Influence of inguinal hernia repair on male fertility. J Visc Surg 155(Suppl 1):S37–S40CrossRefPubMed
29.
Reinpold W, Schroeder AD, Schroeder M, Berger C, Rohr M, Wehrenberg U (2015) Retroperitoneal anatomy of the iliohypogastric, ilioinguinal, genitofemoral, and lateral femoral cutaneous nerve: consequences for prevention and treatment of chronic inguinodynia. Hernia 19:539–548CrossRefPubMed
Metadata
Title
Laparoscopic reoperation for pediatric recurrent inguinal hernia after previous laparoscopic repair
Authors
S. R. Lee
P. J. Park
Publication date
01-08-2019
Publisher
Springer Paris
Published in
Hernia / Issue 4/2019
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-018-1840-y

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