[Laparoscopic inguinal herniorrhaphy in children--experiences in a primary medical care center].
OBJECTIVE
Children undergoing laparoscopic herniorrhaphy may benefit from a minimally invasive access and the possible exploration of the contralateral groin. In this prospective feasibility study, the experiences and results after introduction of this method in a tertiary referral medical center are reported.


METHODS
50 laparoscopic herniorrhaphies were performed in 44 children (32 boys and 12 girls, range: 17 months-11 years) with open inner inguinal rings between January 2001 and March 2007. In 6 children (13.6 %) an additional contralateral open inner inguinal ring was detected. Laparoscopic access was obtained with a 5-mm laparoscope which was inserted transumbilically and two 2-mm needle holders were inserted through the inferolateral abdominal wall. The open inner inguinal rings were closed in 8 children using a resorbable Z-suture and in 36 children using a monofilamentous non-absorbable suture. Follow-up examinations included records of intra- and postoperative complications, recurrence rate and economic aspects.


RESULTS
No intra- or perioperative complications occurred. Median operation time was 19 minutes. 43 / 44 operations were carried on an outpatient basis. Average material costs were about 20 Euro without any difference from the open access. During 36 months the follow-up rate was 91 %. Two children who had previously received an absorbable suture suffered from a recurring groin hernia within the first 6 months.


CONCLUSIONS
Laparoscopic herniorrhaphy in children represents a safe and effective surgical method that can be recommended for tertiary referral medical centers with training facilities and experience in minimally invasive surgery.
Classen
C
C
Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Zentrum für Minimal-Invasive Chirurgie, Herz-Jesu-Krankenhaus Münster.
Palmes
D
D
Horstmann
R
R
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006552:Hernia, Inguinal / Q000191:economics / Q000601:surgery*; D006801:Humans; D007223:Infant; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010045:Outpatients; D011320:Primary Health Care; D012008:Recurrence; D013536:Suture Techniques; D013537:Sutures; D013997:Time Factors