Ultrasonographic findings after laparoscopic repair of paediatric female inguinal hernias: the 'vanishing rosebud'.
BACKGROUND
Laparoscopic surgery is a good alternative to the open technique for treating hernias in female paediatric patients. The laparoscopically inverted and sutured hernia sac forms a nodule, the long-term fate of which has not been previously studied radiologically.


OBJECTIVE
To describe the early and delayed US changes after laparoscopic inversion and suturing of paediatric female inguinal hernias.


METHODS
Twenty girls (age 1.5 months to 12 years; median 4.6 years) who underwent laparoscopic inguinal hernia repair were prospectively evaluated with US the day before and the day after the procedure. Delayed scans were obtained at 1, 6 and 12 months.


RESULTS
The laparoscopic procedure involved inversion and suturing of the hernia sac, which resulted in a nodule that plugged the internal inguinal ring and resembled a rosebud laparoscopically. US detected the 'rosebud' in all cases on the first postoperative day. Initially appearing as a rounded or ovoid mass with a slightly hypoechoic texture, the 'rosebud' became progressively smaller, more hypoechoic and more lobulated on follow-up. It disappeared in all but two cases at 6 months and in all cases at 1 year. There was no US evidence of recurrence.


CONCLUSIONS
The 'rosebud' formed by this laparoscopic procedure displays typical US features and temporal changes.
Akansel
Gur
G
Department of Radiology, Kocaeli University School of Medicine, Derince/Izmit, Turkey. guvench@superonline.com
Guvenc
B Haluk
BH
Ekingen
Gulsen
G
Sozubir
Selami
S
Tuzlaci
Ayse
A
Inan
Nagihan
N
D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D013536:Suture Techniques; D013997:Time Factors; D014463:Ultrasonography