title: Simple Purse String Laparoscopic Versus Open Hernia Repair.
abstract: OBJECTIVE
  To compare surgical outcomes for a simple purse string method of laparoscopic hernia (LH) repair with a traditional open inguinal hernia (OH) repair in children in a single center.
  
  
  METHODS
  Following ethical approval, a retrospective review of all children undergoing LH repair from January 2010 to December 2013 versus a historic cohort of all OH repairs between January 2010 and December 2011 was conducted. LH repair was performed by a simple purse string technique using nonabsorbable braided suture. Groups were compared using the independent t test or the Mann-Whitney test as appropriate.
  
  
  RESULTS
  One hundred three patients (23 females, 80 males) underwent LH repair over the 4-year period compared with 151 (25 females, 126 males) OH procedures in the first 2 years. Median age in the LH group was 0.56 years (range, 0.04-14.7 years) compared with 0.52 years (range, 0.04-13.47 years) in the OH group (P = .81). In the LH group the intended operation was bilateral in 18 (17.4%); 85 were clinically unilateral, but at operation a contralateral patent processus vaginalis was repaired in 26 (30.5%). Median operative time was 50.5 minutes (range, 20-95 minutes) in the LH group and 20 minutes (range, 10-90 minutes) in the OH cohort (P < .0001). Recurrence rate was 2.9% in the LH group and 3.9% in the OH group, and overall complication rates were 7.8% and 9.9%, respectively.
  
  
  CONCLUSIONS
  LH repair yields similar results to OH repair; however, the operation time is significantly longer. All complication rates were statistically similar on balance. Almost one-third of LH procedures resulted in concurrent detection and repair of a contralateral patent processus vaginalis at laparoscopy.
authors.affiliation: Department of Paediatric Surgery, Royal Hospital for Sick Children , Edinburgh, Scotland, United Kingdom .
authors.forename: Mairi
authors.initials: M
authors.lastname: Steven
authors.affiliation: Department of Paediatric Surgery, Royal Hospital for Sick Children , Edinburgh, Scotland, United Kingdom .
authors.forename: Peter
authors.initials: P
authors.lastname: Carson
authors.affiliation: Department of Paediatric Surgery, Royal Hospital for Sick Children , Edinburgh, Scotland, United Kingdom .
authors.forename: Stephen
authors.initials: S
authors.lastname: Bell
authors.affiliation: Department of Paediatric Surgery, Royal Hospital for Sick Children , Edinburgh, Scotland, United Kingdom .
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ward
authors.affiliation: Department of Paediatric Surgery, Royal Hospital for Sick Children , Edinburgh, Scotland, United Kingdom .
authors.forename: Merrill
authors.initials: M
authors.lastname: McHoney
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D061646:Operative Time; D012008:Recurrence; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome