LAPAROSCOPIC TREATMENT OF INGUINAL HERNIA IN CHILDREN, AN EXPERIENCE OF PURSE STRING AT THE LEVEL OF DEEP RING

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Fayaz Ur Rahman
Inayat Ur Rahman
Hazrat Amin

Abstract

Objective: To share our experience of laparoscopic inguinal hernia repair with purse string around deep ring.
Material and Method: This retrospective study was conducted from July 2015 to January 2017 at Pediatric surgery unit
of the Khyber teaching hospital - Peshawar, Pakistan. Children below 16 years with a diagnosis of reducible inguinal
hernia were included. 68 laparoscopic repair of inguinal hernia performed on 60 patients, as 8 patients had bilateral
inguinal hernia. Laparoscpic hernia repair was done with a technique of purse string around the deep ring(PSDR).
Follow up period was of 6 months.Clinical and demographic data were collected and analysed using SPSS 20.
Result: Laparoscopic repair of inguinal hernia repair performed in 60 patients with an intraperitoneal technique of PSDR.
Mean age was about 2.9±2 year and mean weight of 13.3±7.3 Kg. Male to female ratio was 5:1. Unilateral hernia was
in 86.6% and contralateral patent processus vaginalis (CPPV) was found in 33.3%. Operative time for unilateral hernia
repair 39.4±10min and bilateral hernia repair 57.6±8.3min. Wound infection in umbilical port site was 1.6%, hydrocele
6.6% and testicular atrophy 0%. Recurrence recorded in follow up period in 6.6%. Absorbable suture and low skills of
intracorporeal suturing was recorded as a risk factor for recurrence.
Conclusion: Laparoscopic technique of Purse string at the level of deep ring using non-absorbable suture is a safe
and effective method. High rate of recurrence in this technique can be overcome by gaining high skills of intracorporal
suturing and using non-absorbable suture.

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