Laparoscopic Treatment of Inguinal Hernias in Children
Introduction. Interventions for inguinal hernia are the most common surgical procedures in pediatric surgery, their incidence is more than 30 % of all elective surgeries in children. Despite the prevalence of the disease in a population of children, the number of comparative studies of open and laparoscopic approaches to the treatment of inguinal hernia in children is limited. The aim of our study was to evaluate the results of laparoscopic surgery for inguinal hernias in children. Materials and methods. We observed 458 children with inguinal hernias in the period of 2011-2015. All the children underwent elective surgeries. In 120 out of the children, we have used a modified technique consisted in hydraulic dissection of the parietal peritoneum in the internal inguinal ring with the help of pre-injection into the peritoneum of 0.25% solution of novocaine. In order to objectively assess the testicular blood flow in the postoperative period in children with inguinal hernia, we have carried out ultrasound diagnostics with Doppler mapping. Results and discussion. In the analysis of the findings, we have revealed that there were 369 (80 %) cases of single-port operations. 89 children underwent multiport operation. Studies of blood flow in the testicles of children in the first group significantly showed that 26.6 % of them had a reduction of circulation in the testicle on the side of operated hernia. In the second group of patients in the postoperative period no significant deviations from the norm were revealed. Follow-up within a year after surgery showed a low number of late postoperative complications in patients. Only 12 (2.6 %) children in the first group had recurrent hernia, and in 11 (2.4 %) - hydrocele. Conclusions. 1. The majority of operated children were under 2 years of age. 2. The method of laparoscopic herniorrhaphy with hydraulic dissection is accompanied by a lower relapse rate. 3. This technology can be used in any pediatric surgery unit or urological department and can be considered a method of choice in the treatment of children with inguinal hernia.