Skipping The Cord During Laparoscopic Percutaneous Internal Ring Suturing in Children, Is It Reasonable?

Abstract

Abstract Background: Laparoscopic inguinal hernia repair in children was introduced as a minimal invasive method. One of the most common method is percutaneous internal ring suturing (PIRS). The main concern is trapping the spermatic cord and/or damaging the vasculature of testes in boys. This may be avoided with a careful dissection or the surgeon may skip the peritoneum over the cord and/or the vessels. The aim of this study is to compare the recurrence and hydrocele rates of children in whom the peritoneum on the cord and/or vessels was skipped and did not during laparoscopic PIRS repair.Methods: The charts of children who underwent laparoscopic PIRS repair between 2017-2021 due to inguinal hernia were analyzed. Recurrence and complications were evaluated. The video records were watched and the data on skipping(group 1) the peritoneum on vas deferens or not skipping(group 2) the peritoneum on vas deferens was noted. Recurrence and complication rates were compared between groups. Results: A total of 101 boys with 125 inguinal hernia were enrolled. Among these 45 had right-sided, 32 had left-sided and 24 had bilateral inguinal hernias. The video investigation was revealed that there were 63 hernias in group 1 and 62 hernias in group 2. There were two recurrences in each group. No other postoperative complications were observed. Conclusions: For avoiding spermatic cord or vessel damage, skipping the cord seems an acceptable path which seems not to increase recurrence or complication rates and also ensures spermatic structures’ safety.