title: A novel laparoscopic-assisted approach to the repair of pediatric femoral hernias.
abstract: BACKGROUND
  Femoral hernias in young children are relatively rare and can be difficult to diagnose as they are often mistaken for inguinal hernias. Although a few reports have described laparoscopic techniques, most traditional repair methods still focus on an open approach using either an inguinal or crural incision. Here we describe a laparoscopic-assisted technique that is buttressed by a cigarette of mesh for the repair of this uncommon pediatric entity.
  
  
  METHODS
  We report three consecutive cases of children with femoral hernias repaired with only two small incisions: a 5-mm umbilical incision for a 30° camera and a 1-cm groin incision for dissection and ligation of the hernia sac. After sac ligation, the repair was buttressed with a small mesh cigarette.
  
  
  RESULTS
  Using this approach, right femoral hernias were repaired without complication in three children, between 8 and 9 years of age. Two patients had ipsilateral indirect inguinal hernias. No contralateral groin hernias were identified in any of the patients. Operative time averaged 40 minutes, recovery time was quick, and follow-up at 6 months revealed good cosmesis.
  
  
  CONCLUSIONS
  This laparoscopic-assisted approach to pediatric femoral hernia repair with a small mesh plug is a safe, effective, and efficient technique. Because only two incisions are required, postoperative pain is minimal, and cosmesis is excellent. Nonetheless, more patients and longer follow-up will be required to accurately judge the long-term implications of this novel technique.
authors.affiliation: 1 Department of Surgery, Stanford Hospital and Clinics , Stanford, California.
authors.forename: Serena Y
authors.initials: SY
authors.lastname: Tan
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Stevens
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Mueller
mesh_terms: D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D005260:Female; D006550:Hernia, Femoral / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D013526:Surgical Mesh