Laparoscopic repair of congenital inguinal hernia: a comparative study between purse–string suture and peritoneal Hussam S. Hassan, M.D. 2017 Page 13 of 14 disconnection with ligation techniques in bilateral cases

Background/purpose Many laparoscopic surgical techniques were described for management of inguinal hernia in pediatric
patients. This prospective study was conducted to compare laparoscopic purse–string suture of hernia sac at the internal
ring at one side, leaving the distal sac intact (technique I) and disconnection of the hernia sac with intra-corporeal suture of
proximal part at the internal ring (technique II) in the other side in the same case.
Patients and methods Thirty three patients with bilateral congenital inguinal hernia (66 repairs) were included in this study.
The outcome variables were operative time, intraoperative complications, post-operative complications and recurrence rate.
Results This study included 28 males and 5 females. The age of the patients ranged from 1 to 72 month with a mean of
(15.27 ± 19.09). The operative time was shorter in technique I than in technique II and this difference was statistically significant.
No intraoperative complications were reported. Five cases (15%) developed hydrocele and two cases (6%) developed
recurrence in technique I during the follow up period.
Conclusion Laparoscopic repair of congenital inguinal hernia using laparoscopic disconnection of the sac and closure of
the internal ring has lower recurrence rate and hydrocele formation but longer operative time compared to laparoscopic
purse–string closure alone. Due to the high rate of recurrence in technique I, there is definite superiority of technique II as
a surgical option.