Method of laparoscopic hernioplasty in children with inguinal hernia with large sizes of the inner inguinal ring

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MATERIALS AND METHODS

During the period from 2000 to 2021, 3.293 children with inguinal hernia were treated in the surgical department. Out of 3590 operations performed in these patients, 1269 operations were performed using the method of extraperitoneal laparoscopic herniation. For the study, the first group included 18 patients with an inguinal hernia and a diameter of the inner inguinal ring greater than three centimeters, operated by the method of extraperitoneal laparoscopic herniation with a spinal needle Tuohy. The second group included 12 patients with an inguinal hernia and a diameter of the inner inguinal ring greater than three centimeters using the method we proposed.

RESULTS

Long-term results were followed up in the period from 2 months to 6 years. In the first group, relapse occurred in 6 patients (33.3%). In 6 patients, when the ligature was tightened around the large diameter of the inner inguinal ring with significant tension, the latter ruptured, which required a repeat of the surgical procedure. In all cases, due to the large diameter of the inner inguinal ring, deformation of the spinal needles used for retroperitoneal ligatures occurred intraoperatively, with the destruction of the needles Tuohy along the level of its pavilion in two cases. In the second group of children operated using a new method of hernia repair, there was no recurrence of the disease and no technical intraoperative problems.

CONCLUSION

The proposed method of laparoscopic treatment of inguinal hernia with large sizes of the inner inguinal ring in children allowed to reduce the risk of intraoperative and postoperative complications, made it possible to guarantee the elimination of inguinal hernia with the size of the inner inguinal ring more than three centimeters and, as a result, improved the results of surgical treatment of children with inguinal hernia.

Keywords:

inguinal hernia

laparoscopic herniation

inner inguinal ring

Authors:

Svarich V.G.

Republican Children’s Clinical Hospital;
Pitirim Sorokin Syktyvkar State University

ORCID: 0000-0002-0126-3190

Kagantsov I.M.

Pitirim Sorokin Syktyvkar State University;
Almazov National Medical Research Center

SPIN RSCI: 7936-8722
ORCID: 0000-0002-3957-1615

Svarich V.A.

Main Bureau of Medical and Social Expertise in the Republic of Komi

ORCID: 0000-0003-0858-1463

Received:

14.06.2021

Accepted:

18.08.2021

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