Laparoscopic Hernia Repair versus Open Herniotomy in Children: A Controlled Randomized Study

Rafik Shalaby, Refaat Ibrahem, Mohamed Shahin, Abdelaziz Yehya, Mohamed Abdalrazek, Ibrahim Alsayaad, Maged Ali Shouker, Rafik Shalaby, Refaat Ibrahem, Mohamed Shahin, Abdelaziz Yehya, Mohamed Abdalrazek, Ibrahim Alsayaad, Maged Ali Shouker

Abstract

Background. Laparoscopic hernia repair in infancy and childhood is still debatable. The objective of this study is to compare laparoscopic assisted hernia repair versus open herniotomy as regards operative time, hospital stay, postoperative hydrocele formation, recurrence rate, iatrogenic ascent of the testis, testicular atrophy, and cosmetic results. Patients and Methods. Two hundred and fifty patients with inguinal hernia were randomized into two equal groups. Group A was subjected to laparoscopic inguinal hernia repair. Group B was subjected to open herniotomy. The demographic data were matched between both groups. Assessment of the testicular volume and duplex assessment in preoperative, early, and late postoperative periods were done. Results. All cases were completed successfully without conversion. The mean operative time for group A was 7.6 ± 3.5 minutes, 9.2 ± 4.6 minutes and 11.4 ± 2.7 minutes, for unilateral hernia, unilateral hernia in obese child, and bilateral hernia, respectively. The recurrence rate was 0.8% in group A, whereas in group B the recurrence rate was 2.4%. Conclusion. Laparoscopic hernia repair by RN is an effective line of hernia repair. It resulted in marked reduction of operative time, low rate of recurrence, no testicular atrophy, no iatrogenic ascent of the testis, and excellent cosmetic results.

Figures

Figure 1
Figure 1
Reverdin needle.
Figure 2
Figure 2
Insertion of RN on the right side.
Figure 3
Figure 3
(a) Bilateral huge inguinal hernia. (b) Postoperative view.
Figure 4
Figure 4
Right inguinal hernia postoperative view with ugly scar.
Figure 5
Figure 5
(a) Testicular Doppler U/S showed no signs of ischemia with good blood flow. (b) Testicular Doppler U/S showed poor blood flow.
Figure 6
Figure 6
Left testicular atrophy after open herniotomy.

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Source: PubMed

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