Comparison of Laparoscopic Needle-Assisted Extra-Corporeal Inguinal Hernia Repair with Intracorporeal Inguinal Hernia Repair in Terms of Postoperative Recurrence

Abstract

Objective: To compare laparoscopic needle-assisted extra-corporeal hernia repair regarding recurrence in children with
intracorporeal repair.

Study Design: Retrospective longitudinal study.

Department of Paediatric Surgery, Pak Emirates Military Hospital, Rawalpindi Pakistan, from
Jul 2019 to Dec 2020.

Methodology: Retrospectively, all patients who underwent laparoscopic herniotomy were searched through hospital records.Ninety-seven patients matched the inclusion criteria out of 148 laparoscopic surgeries. All patients were diagnosed with inguinal hernia based on history and clinical examination. Fifty-one patients underwent laparoscopic needle-assisted repair (LNAR) with extra-corporeal knotting, whereas 46 underwent repair with intracorporeal knotting of the deep inguinal ring. Pneumoperitoneum was created in all cases by open method. All patients were followed up for six months outdoors for recurrence.

Results: The age of patients ranged from 1-12 years; the mean age of study patients was 5.29±3.17 years. Regarding the
inguinal hernia site, 45(46.4%) had a right-sided hernia, and 52(53.6%) had a left-sided hernia. All operations were completed laparoscopically. There were no intraoperative complications. A total of 2(3.53%) patients developed recurrence, one from each group, 2.17% in Group-A and 1.96% in Group-B, with no statistically significant difference between the two groups after six months of follow-up (p-value=0.942).

Conclusion: Extra-corporeal knotting in children with inguinal hernia is an effective, quick and safe technique. It is
comparable to the standard intracorporeal knotting technique in terms of recurrence.