Sutureless inguinal hernia repair with creation of a peritoneal lesion in children: a novel laparoscopic technique with a low recurrence rate.

BACKGROUND: Hernia repair represents about 25% of all pediatric surgeries. Repair can be done using an open or laparoscopic technique. The open approach has a reported recurrence rate of 1.2% but requires an additional incision to repair for a contralateral hernia. With the laparoscopic approach, no additional incision is needed but the recurrence rate has been reported to be as high as 4%. The objective of this study was to assess the safety and efficacy of a novel sutureless laparoscopic inguinal hernia repair that has the advantages of both approaches.

METHODS: Since April 2014 up to March 2017, 26 children (12 girls and 14 boys) aged 3 months to 13 years underwent sutureless laparoscopic inguinal hernia repair. The peritoneum around the internal inguinal ring was severed and folded into the inguinal canal. Regeneration of the peritoneum around the inguinal ring creates a scar that effectively closes the internal orifice.

RESULTS: No recurrences or complications were observed in any of the 26 cases after a follow-up of 1-35 months (median, 14 months).

CONCLUSIONS: Sutureless laparoscopic inguinal hernia repair provides a new option for the management of patients with a pediatric inguinal hernia. The procedure does not require advanced laparoscopic skills, is easily reproducible, and is safe.

THERAPEUTIC STUDY: Level of Evidence IV.