title: Percutaneous internal ring suturing is a safe and effective method for the minimal invasive treatment of pediatric inguinal hernia: Experience with 250 cases.
abstract: OBJECTIVE
  Percutaneous internal ring suturing (PIRS) is a minimally invasive method for repair of pediatric inguinal hernia. In this study we report our experience with PIRS.
  
  
  METHODS
  All children >10kg presenting to our institute between June 2013 and March 2015 with a diagnosis of indirect inguinal hernia or communicating hydrocele underwent laparoscopic repair using PIRS technique. Patients' gender, age at surgery, side of inguinal hernia/communicating hydrocele at diagnosis, peroperative findings, surgical and anesthesia times plus follow-up findings were collected.
  
  
  RESULTS
  Two-hundred thirteen patients underwent 250 procedures. Inguinal hernia or communicating hydrocele was diagnosed on the right side in 113 (53.1%), the left side in 75 (35.2%) and bilaterally in 25 patients (11.7%). Contralateral hernia was found in 35 patients (16.4%). Mean surgery time was 14.3min for unilateral and 20.4min for bilateral PIRS, and mean anesthesia time was 33.6min for unilateral and 39.1min for bilateral PIRS. Average follow-up time was 9.6months. Recurrence was seen in 3 (1.4%) and complications in 6 patients (2.8%).
  
  
  CONCLUSIONS
  PIRS is a simple, safe and effective method for the treatment of inguinal hernia and communicating hydrocele in children.
authors.affiliation: Pendik State Hospital, Department of Pediatric Surgery, Istanbul, Turkey. Electronic address: david@thomas.md.
authors.forename: David Terence
authors.initials: DT
authors.lastname: Thomas
authors.affiliation: Pendik State Hospital, Department of Pediatric Surgery, Istanbul, Turkey.
authors.forename: Kamil Basar
authors.initials: KB
authors.lastname: Göcmen
authors.affiliation: Pendik State Hospital, Department of Anesthesiology & Reanimation, Istanbul, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Tulgar
authors.affiliation: Pendik State Hospital, Department of Anesthesiology & Reanimation, Istanbul, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Boga
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007223:Infant; D007264:Inguinal Canal / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D013536:Suture Techniques; D006848:Testicular Hydrocele / Q000601:surgery*
keywords: Complication; Inguinal hernia; Laparascopic; Minimal invasive; Pediatric; Percutaneous internal ring suturing; Recurrence