Laparoscopic Inguinal Hernia Repair in Pediatric Female Patients Using Cautery and Endoloops: Description of Technique and Outcomes

Abstract

Purpose:

Multiple techniques have been described for laparoscopic inguinal hernia repair in children. The purpose of this study was to describe our experience using cautery and Endoloops in pediatric female patients.

Methods:

We conducted a retrospective review of pediatric female patients who underwent laparoscopic inguinal hernia repair using cautery and Endoloops at our center. This technique involves establishing laparoscopic access through the umbilicus, everting and cauterizing the hernia sac with a Maryland dissector, and placing two PDS Endoloops at the level of the internal ring. Outcomes included operative time and complications.

Results:

We identified 50 female patients (mean age 5.6 years, range 2 months to 17 years) who underwent laparoscopic inguinal hernia repair using cautery and Endoloops from January 2015 to March 2024. The indication for surgery in most patients was a clinical hernia (n = 43/50). One of these was incarcerated and another was a recurrent hernia. Seven other patients underwent ligation of an incidental patent processus vaginalis during laparoscopic appendectomy (n = 4), laparoscopic ovarian detorsion (n = 2), or diagnostic laparoscopy for possible Meckel’s diverticulum (n = 1). Median operative time was 30 minutes for unilateral inguinal hernias (n = 26/43) and 33 minutes for bilateral (n = 17/43). None experienced conversion to open procedure, surgical site infection, or recurrence.

Conclusion:

We conclude that laparoscopic inguinal hernia repair using cautery and Endoloops is safe and effective in pediatric female patients. This technique does not require specialized skills, training, or equipment. We have used this approach for primary repair of clinical hernia, incarcerated hernia, recurrent hernia, and incidental patent processus vaginalis.