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CLINICAL INTRA OPERATIVE TOOL TO DETERMINE THE ADEQUACY OF LAPAROSCOPIC INGUINAL HERNIA REPAIR IN PEDIATRICS.

Muhammad Armughan1, Malik Muhammad Makki2, Muhammad Tariq1, Javed Iqbal1, Samia Yunas3. 1Bahawal Victoria Hospital, Bahawalpur, 2Sheikh Khalifa Medical City Ajman, UAE, 3Emirates Specialty Hospital, Dubai

INTRODUCTION: Laparoscopic Inguinal hernia repair in pediatric is a safe and feasible procedure. There are two main approaches which has been successfully practiced are extra peritoneal and intraperitoneal. Recurrence in case of laparoscopic repair consider more than open repair. We develop a intraoperative clinical tool or method which could reassure adequacy of repair.

METHODS AND PROCEDURE: It is a common practice to evacuate air or fluid from the scrotum or labia before tying a suture around internal opening and ligating the hernia. We used scrotal air to check air tight closure of internal ring. We first encircle and tie internal ring in our laparoscopic technique. Later assistant hold the scrotum and push than push scrotal inside abdomen. Operating surgeon should check air air leak at level of internal opening . We assumed if internal ring is air tight close than chances of recurrence inguinal hernia me be minimum.

We used all male pediatric patients who can accumulate enough air in their scrotum during pneumoperitoneum. We followed patient first 06 months than 1 year for recurrence.

RESULT: There were fifteen (15) male child patient who were analyzed intraoperative and followed at 06 month and 1 –year. There was one case with intraoperative air leak at internal opening. This patient was tied again securely without air leak. Same patient got recurrence at at 10months. Three patients missed their one year follow-up. We did not notice recurrence in remaining patients.

CONCLUSION: This was a small study based on the fact that air tight internal ring might have less chance of recurrence. Which were observed in majority of our patients. Only one patient developed recurrence even with air tight closure of internal ring. We checked retrospectively and found thin peritoneal layers at internal ring. We concluded religating the internal opening might have weakened the internal ring which cause recurrence.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95313

Program Number: P587

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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