title: Laparoscopic hernia repair in children by the hook method: a single-center series of 433 consecutive patients.
abstract: BACKGROUND
  The relatively high recurrence rate reported in laparoscopic hernia repair in children using intracorporeal suturing technique remains a concern. We aimed to investigate the effectiveness of the hook method during hernia repair that allows extraperitoneal passage of suture to close the hernia sac without creating any tension or skip areas and does not require laparoscopic suturing skills.
  
  
  METHODS
  A retrospective review was conducted on 433 consecutive children who underwent laparoscopic hernia repair using the hook method by 1 of 4 surgeons from July 2004 to June 2007.
  
  
  RESULTS
  A total of 572 successful laparoscopic hernia repairs were performed among the 433 children with an age range of 1 week to 15 years (mean = 56 months). Conversion rate was 1.04%. Contralateral patent processus vaginalis was found in 26.8%. Mean operating time was 23.8 and 40.2 minutes for unilateral and bilateral repair, respectively. At a median follow-up of 20 months, there were 2 recurrences (0.35%), 2 hydroceles, 1 ascending testis, and 1 instance of testicular atrophy. No serious complications were associated with the procedure.
  
  
  CONCLUSIONS
  Medium-term results suggest that laparoscopic hernia repair with the hook method is a sound alternative to open herniotomy in children.
authors.affiliation: Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. pyhtam@hotmail.com
authors.forename: Yuk Him
authors.initials: YH
authors.lastname: Tam
authors.forename: Kim Hung
authors.initials: KH
authors.lastname: Lee
authors.forename: Jennifer Dart Yin
authors.initials: JD
authors.lastname: Sihoe
authors.forename: Kin Wai
authors.initials: KW
authors.lastname: Chan
authors.forename: Pui Yiu
authors.initials: PY
authors.lastname: Wong
authors.forename: Sing Tak
authors.initials: ST
authors.lastname: Cheung
authors.forename: Jennifer Wai Cheung
authors.initials: JW
authors.lastname: Mou
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome