Laparoscopic Needle Assisted Technique for Repair of Inguinal Hernias in Children

Video Type: CVideo
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Author: Andre Hebra
Published:
Specialties: Pediatric Surgery
Schools: Medical University of South Carolina
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Basic Info

Contributors:

Chris Streck (MUSC)

Aaron Lesher (MUSC)

Robert Cina (MUSC)

Step-by-step demonstration on how to perform the laparoscopic needles assisted repair (LNAR) of inguinal hernias in infants and young children.

This fairly new technique for laparoscopic repair of inguinal hernias in infants and children is now well accepted among many pediatric surgeons. Because of the very small skin incisions, it is associated with minimal pain and has great cosmetic appeal. The operation is indicated in the treatment of inguinal hernias and communicating hydroceles in children less than 12 years of age. Preliminary results reported by the authors have suggested a similar recurrence rate as reported for the open technique. Interestingly, the recurrence rate is lower in small and premature infants compared to open surgery. The authors prefer the use of non-absorbable suture (like Prolene) in order to minimize the risk of recurrence. Our experience has demonstrated that the laparoscopic needle-assisted repair of inguinal hernia is safe with a 4% rate of minor complications. The most common complication is the development of a suture granuloma at the site of the suture placement for closure of the internal inguinal ring. It usually can be treated medically. In rare occasions, it might be necessary to remove the suture. Other less common reported complications include infection, residual hydrocele, hernia recurrence, and injury to the spermatic vessels or vas.

DOI: http://dx.doi.org/10.17797/bdmv3e7y2c

Editor Recruited By: Robert Shamberger, MD

Advanced

Procedure

Laparoscopic Needle Assisted Repair of Inguinal Hernia in infants and children

Indications

Repair of pediatric indirect inguinal hernias and communicating hydroceles

Contraindications

None

Instrumentation

Setup

Preoperative Workup

Anatomy and Landmarks

Advantages/Disadvantages

Complications/Risks

Disclosure of Conflicts

Acknowledgements

References

McClain L, Streck C, Lesher A, Cina R, Hebra A: Laparoscopic needle-assisted inguinal hernia repair in 495 children. Surg Endosc 2015; 29: 781-786. doi: 10.1007/s00464-014-3739-8.

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