Benefits of laparoscopic posterior wall suture repair in treating adolescent indirect inguinal hernias

Purpose

Adolescent inguinal hernias are treated using high ligation or posterior wall suture repair with laparoscopic mesh implantation. This study aimed to evaluate the efficacy of laparoscopic intracorporeal posterior wall suture repair without mesh implantation for treating adolescent indirect inguinal hernias.

Methods

Laparoscopic herniorrhaphy was performed between September 2012 and April 2015 in 244 patients aged 11–18 years who were diagnosed with indirect inguinal hernias at Damsoyu Hospital, Seoul, Korea. The patients were stratified by surgical procedure into the high-ligation (115 patients) and wall suture (129 patients) groups.

Results

Four (3.5%) of the 115 patients in the high-ligation group experienced recurrence, but those in the wall suture group did not. The difference in recurrence rates between these groups was significant (p < 0.001). The wall suture procedures were longer (mean 28.2 min) than the high-ligation procedures (mean 17.4 min) (p < 0.001). The lengths of postoperative hospital stays were similar in both groups. Few complications were observed: one patient developed hematoma and one developed seroma in the high-ligation group; two patients developed inguinal hematomas and one developed seroma in the wall suture group. Visual analog scale scores at 1 week after surgery and the mean times to return to normal activities were similar in both groups. No chronic inguinodynia after the operation in either group was observed.

Conclusions

Laparoscopic intracorporeal posterior wall suture repair without mesh implantation was effective for treating adolescent indirect inguinal hernias and resulted in fewer recurrences than those with high ligation.