Inguinal herniation in children

A minimally invasive approach to the treatment of various surgical diseases and malformations is increasingly being used in pediatric surgery, however, in some cases, the traditional open access method is also used.Laparoscopic inguinal hernia surgery was first performed and described in 1993. Nevertheless, the optimal treatment method for this disease in children is still a matter of debate.

In статье Ciro Esposito and co-authors compared the results of laparoscopic (PH) and open hernia surgery (OH) in children. The authors analyzed all the results of PH and OH published over the past 20 years, namely: the duration of surgery, the frequency of recurrence and other complications, the detection of rare types of hernia and the frequency of detection of contralateral hernia. The analysis conducted by the authors showed that PH is faster than OH in bilateral hernia, however, in unilateral inguinal hernia there are no significant differences between the two procedures. At the same time, the duration of the operation varied widely, depending on the technique and experience of the specialists who performed it. The recurrence rate was the same for both techniques, while the rates of other complications, such as wound infections, were significantly higher for OH than for PH, especially in infants.

Original article in EnglishTranslation of the original article

Laparoscopic hernioraphy (herniation) is widely used by pediatric surgeons and pediatric urologists in leading clinics in our country and abroad. Laparoscopic access is the method of choice when performing inguinal herniation at the EMC Children's Clinic, as it allows not only to effectively cure the disease, but also to simultaneously identify and eliminate a hernia on the other side. The advantages of PH include better visualization of the vital structures of the spermatic cords, which makes the excision procedure safer and damage to the vas deferens is almost impossible.

In our work, we use a unique technique for performing laparoscopic herniation, developed by the surgeon of our clinic, Dr. By Roman Ignatiev, using patented tools. After such an operation, barely noticeable traces remain on the abdominal wall of the child – 3.5 mm near the navel and 2 mm in the projection of the hernia itself. An important factor is the short rehabilitation time for small patients and a significant reduction in the postoperative pain effect.

A minimally invasive approach to solving the problem of surgical treatment of inguinal hernia allows these operations to be performed in a "one-day hospital". Our experience shows that this significantly reduces the frequency of relapses and complications compared with OH. We believe that laparoscopic surgery certainly has significant and undeniable advantages over traditional "open" inguinal herniation in children.