Video-assisted percutaneous hernia sac suturing: a new technique of inguinal hernia repair in children

Background. Inguinal hernias are very important problem in pediatric surgery. It appears in 5–20 cases in every 1000 newborns, approximately 10 times prevalence in males. However, the incidence of inguinal hernia is bigger by 1.5–2 times in group of premature infants.

Materials and methods. In prospective study, that was performed in 2019–2020, 90 pediatric patients diagnosed inguinal hernia were included. All patients had open herniotomy (Duhamel method), subcutaneous endoscopic-assisted ligation of inguinal hernia using Tuohy needle, or video-assisted percutaneous hernial sac suturing (VIPS).

Results. The mean operating time in VIPS group was 13 ± 13.46 min in patients with unilateral inguinal hernia and 20 ± 6.12 min in patients with bilateral variant. In the 6-month follow-up period, any complications or recurrences were not observed. VIPS group included two extremely premature infant with uni- and bilateral inguinal hernia. Minimally invasive herniotomy was performed in 50 weeks post-conceptual age, with unremarkable postoperative period. A difference was found in the operating time between groups of minimally invasive herniotomy and group of Duhamel repair. No difference was found in the operating time of bilateral hernia between all groups.

Conclusion. Considered all things, assuming that announced method of video-assisted percutaneous hernial sac ligation to be a perspective minimal invasive way of treatment for inguinal hernia in children is reasonable. However, for final conclusions, further study of this surgical technique, also in a cohort of premature infants, is required, with the possible organization of multicenter clinical trials.