title: Laparoscopic Pediatric Inguinal Hernia Repair: A Pilot Study in a Novel Guinea Pig Animal Model.
abstract: BACKGROUND
  The purpose of this study was to compare different techniques for pediatric laparoscopic inguinal hernia repair. We hypothesize that the amount of dissection performed at the internal ring, with or without division of the peritoneum, will impact healing and thus long-term success of the repair.
  
  
  METHODS
  Following the Institution's Animal Care and Use Committee approval (708024-4), 20 Hartley guinea pigs underwent laparoscopic repair of their natural open internal rings. The guinea pigs were divided equally into four surgical groups: intracorporeal suture repair (IS), hernia dissection and division with intracorporeal suture (DDIS) repair, subcutaneous endoscopically assisted ligation (SEAL), and Yueng (HOOK) repair. After a 6-week survival period, a necropsy was performed. Repairs were evaluated and tested under pressures up to 30 mmHg. The suture was then removed to assess primary healing. Experimental data were analyzed using chi-square test.
  
  
  RESULTS
  There were no perioperative or postoperative complications. On initial evaluation, before suture removal, repair integrity was as follows: 5/10 IS, 10/10 DDIS, 7/10 SEAL, and 7/10 HOOK (P = .09). After suture removal, repair integrity was as follows: 3/10 IS, 10/10 DDIS, 5/10 SEAL, and 6/10 HOOK (P = .01).
  
  
  CONCLUSIONS
  Overall, dissecting and dividing the sac with intracorporeal suture (DDIS) closure had the best outcome. This method appears to best replicate standard open high ligation.
authors.affiliation: 1 Baystate Medical Center, Tufts University School of Medicine , Springfield, Massachusetts.
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Mora
authors.affiliation: 1 Baystate Medical Center, Tufts University School of Medicine , Springfield, Massachusetts.
authors.forename: Katharine R
authors.initials: KR
authors.lastname: Bittner
authors.affiliation: 1 Baystate Medical Center, Tufts University School of Medicine , Springfield, Massachusetts.
authors.forename: Kaitlyn E
authors.initials: KE
authors.lastname: Wong
authors.affiliation: 2 Baystate Children's Hospital, Tufts University School of Medicine , Springfield, Massachusetts.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Moriarty
authors.affiliation: 2 Baystate Children's Hospital, Tufts University School of Medicine , Springfield, Massachusetts.
authors.forename: David B
authors.initials: DB
authors.lastname: Tashjian
authors.affiliation: 2 Baystate Children's Hospital, Tufts University School of Medicine , Springfield, Massachusetts.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Tirabassi
mesh_terms: D000818:Animals; D016009:Chi-Square Distribution; D002648:Child; D004195:Disease Models, Animal; D006168:Guinea Pigs; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D010865:Pilot Projects; D011183:Postoperative Complications; D011897:Random Allocation; D013537:Sutures; D016896:Treatment Outcome; D014945:Wound Healing
keywords: hernia repair; inguinal hernia; laparoscopy; pediatric