Fayaz-ur Rahman, Inayat-ur Rahman, Hazrat Amin.
Laparoscopic treatment of inguinal hernia in children, an experience of purse string at the level of deep ring.
J Med Sci Jan ;27(2):111-5.

Objective: To share our experience of laparoscopic inguinal hernia repair with purse string around deep ring. Material and Method: This retrospective study was conducted from July 2015 to January 2017 at Pediatric surgery unit of the Khyber teaching hospital - Peshawar, Pakistan. Children below 16 years with a diagnosis of reducible inguinal hernia were included. 68 laparoscopic repair of inguinal hernia performed on 60 patients, as 8 patients had bilateral inguinal hernia. Laparoscpic hernia repair was done with a technique of purse string around the deep ring (PSDR). Follow up period was of 6 months. Clinical and demographic data were collected and analysed using SPSS 20. Result: Laparoscopic repair of inguinal hernia repair performed in 60 patients with an intraperitoneal technique of PSDR. Mean age was about 2.9+/-2 year and mean weight of 13.3+/-7.3 Kg. Male to female ratio was 5:1. Unilateral hernia was in 86.6% and contralateral patent processus vaginalis (CPPV) was found in 33.3%. Operative time for unilateral hernia repair 39.4+/-10 min and bilateral hernia repair 57.6+/-8.3min. Wound infection in umbilical port site was 1.6%, hydrocele 6.6% and testicular atrophy 0%. Recurrence recorded in follow up period in 6.6%. Absorbable suture and low skills of intracorporeal suturing was recorded as a risk factor for recurrence.Conclusion: Laparoscopic technique of Purse string at the level of deep ring using non-absorbable suture is a safe and effective method. High rate of recurrence in this technique can be overcome by gaining high skills of intracorporal suturing and using non-absorbable suture.

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