Laparoscopic flip flap technique versus conventional inguinal hernia repair in children

ABSTRACT

Inguinal hernia repair is one of the most frequently performed pediatric surgical operations. Due to recent wide usage of laparoscopy in surgical practice, several techniques of pediatric laparoscopic inguinal hernia repair were introduced. There is still unresolved debate regarding the feasibility of laparoscopy for treating pediatric inguinal hernia. A retrospective cohort study was done enrolling 33 patients, who underwent congenital inguinal hernia repair in the pediatric surgery department, Zagazig University from July, 2004, to October, 2004, by either new laparoscopic flip flap technique or conventional open repair. Patients were divided into two groups according to the type of surgery done, Group A, who underwent the new laparoscopic technique and Group B, who underwent conventional open repair. Group A included 15 patients [mean age 39 months], Group B included 18 patients [mean age 44 months].The mean operative time was 47.5 minutes for Group A, while in Group B mean operative time was 27.5 minutes. In group A, Intraoperative complications included injury of vas deferens in one patient [7%], and tearing of the flaps during suturing in 3 [20%]. No intraoperative complications were encountered in Group B. In both groups, the mean postoperative hospital stay was 5.5 hours. Postoperative follow-up for 6 months revealed recurrence in 4 cases in Group A [27%], while no recurrences occurred in Group B. Our preliminary experience showed unsatisfactory outcome with the laparoscopic flip-flap hernia repair in children. In spite of advancement in the application of laparoscopy in pediatric surgery, conventional open hernia repair is still the gold standard in this age group