Laparoscopic flip-flap technique versus conventional inguinal hernia repair in children.
OBJECTIVE
Inguinal hernia repair is one of the most frequently performed pediatric surgical operations. Several pediatric laparoscopic inguinal hernia repair techniques have been introduced. But debate is unresolved regarding the feasibility of laparoscopy for treating pediatric inguinal hernias.


METHODS
A retrospective cohort study enrolled 33 patients who underwent congenital inguinal hernia repair by either the new laparoscopic flip-flap technique or conventional open repair. Patients were divided into 2 groups according to the type of surgery: Group A included those who underwent the new laparoscopic technique, and Group B included those who underwent conventional open repair.


RESULTS
Group A comprised 15 patients (mean age, 39 months), and group B comprised 18 (mean age, 44 months). Mean operative time was 47.5 minutes for Group A versus 27.5 minutes for Group B. Intraoperative complications for Group A included 1 case (7%) of vas deferens injury, and 3 cases (20%) in which the flaps were torn during suturing. In Group B, no intraoperative complications were encountered. In both groups, the mean postoperative hospital stay was 5.5 hours. Postoperative follow-up of 3 months revealed recurrence in 4 patients in Group A (27%), while there were no recurrences in Group B.


CONCLUSIONS
Our preliminary experience shows unsatisfactory outcomes with laparoscopic flip-flap hernia repair in children. In spite of advancement in the application of laparoscopy in pediatric surgery, conventional open hernia repair is still the gold standard for children, in our experience. Future studies with more numbers and longterm follow-up should be conducted.
Hassan
Mohamed E
ME
Pediatric Surgery Department, Alwasl Hospital, Dubai, United Arab Emirates. dmia88@hotmail.com
Mustafawi
A R
AR
D002648:Child; D002675:Child, Preschool; D006552:Hernia, Inguinal / Q000151:congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D013524:Surgical Flaps