title: Early experience with needleoscopic inguinal herniorrhaphy in children.
abstract: OBJECTIVE
  To validate its safety and efficacy, the authors evaluated their early experience with needleoscopic inguinal herniorrhaphy in children.
  
  
  METHODS
  Twelve consecutive children, older than 6 months, with unilateral (n = 8) or bilateral (n = 4) inguinal hernias underwent a needleoscopic herniorrhaphy. A 1.7-mm needle laparoscope was introduced through the umbilicus, and a grasper placed laterally was used for traction. A curved stainless steel awl introduced percutaneously anterolateral to the internal ring was used to pass a ligature circumferentially to complete an extraperitoneal high ligation of the sac (without handling the vas deferens and spermatic vessels in males). Four of 12 patients underwent their repair combined with other procedures. Children who underwent herniorrhaphy only were allowed immediate return to unrestricted activity. Data recorded with IRB approval included operating time, postoperative discomfort, recurrence, and complications.
  
  
  RESULTS
  For herniorrhaphy only the mean operating time was 23 minutes (unilateral, n = 5) or 46 minutes (bilateral, n = 3). All were able to return to immediate unrestricted activity. None required any analgesics other than acetaminophen. There were no recurrences or complications.
  
  
  CONCLUSIONS
  Needleoscopic inguinal herniorrhaphy in children is safe and effective. This technique potentially offers less risk of injury to cord structures with a superior cosmetic result.
authors.affiliation: University of Tennessee College of Medicine, Le Bonheur Children's Medical Center, Memphis, TN, USA.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Prasad
authors.forename: Harold N
authors.initials: HN
authors.lastname: Lovvorn
authors.forename: George M
authors.initials: GM
authors.lastname: Wadie
authors.forename: Thom E
authors.initials: TE
authors.lastname: Lobe
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009339:Needles