Chris Streck (MUSC)
Aaron Lesher (MUSC)
Robert Cina (MUSC)
Step-by-step demonstration on how to perform the laparoscopic needles assisted repair (LNAR) of inguinal hernias in infants and young children.
This fairly new technique for laparoscopic repair of inguinal hernias in infants and children is now well accepted among many pediatric surgeons. Because of the very small skin incisions, it is associated with minimal pain and has great cosmetic appeal. The operation is indicated in the treatment of inguinal hernias and communicating hydroceles in children less than 12 years of age. Preliminary results reported by the authors have suggested a similar recurrence rate as reported for the open technique. Interestingly, the recurrence rate is lower in small and premature infants compared to open surgery. The authors prefer the use of non-absorbable suture (like Prolene) in order to minimize the risk of recurrence. Our experience has demonstrated that the laparoscopic needle-assisted repair of inguinal hernia is safe with a 4% rate of minor complications. The most common complication is the development of a suture granuloma at the site of the suture placement for closure of the internal inguinal ring. It usually can be treated medically. In rare occasions, it might be necessary to remove the suture. Other less common reported complications include infection, residual hydrocele, hernia recurrence, and injury to the spermatic vessels or vas.
Editor Recruited By: Robert Shamberger, MD