title: Laparoscopic inguinal hernia repair in the pediatric age group--experience with 437 children.
abstract: OBJECTIVE
  A retrospective analysis of prospectively collected data of pediatric patients that underwent laparoscopic inguinal hernia repair.
  
  
  METHODS
  A retrospective review was performed of the prospectively collected data of 576 laparoscopic internal ring closures in 437 children (age, 30 days-11 years; median, 1.9 years) from June 1999 to February 2009. The internal ring was closed with a 3-0 nonabsorbable suture. Both extracorporeal and intracorporeal methods of knotting were used. All patients were asked to return at 1 week and 6 weeks postoperatively for routine follow-up.
  
  
  RESULTS
  A contralateral patent processus vaginalis was present in 13% (45/352) of boys and 15% (12/83) of girls on the right side, and 7% (25/352) of boys and 6% (5/83) of girls on the left side. Follow-up range was from 1 week postoperatively to 108 months. There were 14 recurrences (2.4 % [14/576], 11 in boys and on the right side and 3 in girls) and 2 hydroceles 0.35% (2/576). Mean operating time was 23 minutes for unilateral and 29 minutes for bilateral inguinal hernia. There was neither metachronus hernia nor testicular atrophy observed during follow-up.
  
  
  CONCLUSIONS
  Laparoscopic inguinal hernia repair is technically easier, as there is no need to dissect the vas deferens and vessels. The risk of metachronous hernia is reduced, and we believe the cosmetic result is better. Although recurrences were more common early in the series, currently they are much less frequent. Laparoscopic inguinal hernia repair appears to have less morbidity than open herniotomy and can be used as routine procedure in the pediatric age group.
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India. sandeshparelkar@kem.edu
authors.forename: Sandesh V
authors.initials: SV
authors.lastname: Parelkar
authors.forename: Sanjay
authors.initials: S
authors.lastname: Oak
authors.forename: Rahul
authors.initials: R
authors.lastname: Gupta
authors.forename: Beejal
authors.initials: B
authors.lastname: Sanghvi
authors.forename: Pradeep H
authors.initials: PH
authors.lastname: Shimoga
authors.forename: Deepak
authors.initials: D
authors.lastname: Kaltari
authors.forename: Advait
authors.initials: A
authors.lastname: Prakash
authors.forename: Raj
authors.initials: R
authors.lastname: Shekhar
authors.forename: Abhaya
authors.initials: A
authors.lastname: Gupta
authors.forename: Mitesh
authors.initials: M
authors.lastname: Bachani
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007194:India; D007223:Infant; D010535:Laparoscopy; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome