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Laparoscopic iliopubic tract repair for pediatric inguinal hernia has very low recurrence: an Indian experience
  1. Sunil Kumar Nayak,
  2. Ramakrishnan Parthasarathi,
  3. Raghavendra Gupta G H V,
  4. Subbaiah Rajapandian,
  5. Nalankilli Vaiyapurigoundar Palanisamy and
  6. Chinnusamy Palanivelu
  1. Minimal Access Surgery, GEM Hospital and Research Centre, Coimbatore, Tamil Nadu, India
  1. Correspondence to Dr Sunil Kumar Nayak; nayaksunil0203{at}


Background The aim of this study is to document results of laparoscopic iliopubic tract (IPT) repair for inguinal hernia in the pediatric age group.

Methods Hospital records of 190 children who underwent IPT repair between January 2015 and January 2020 were analyzed retrospectively for demographic details, variations between clinical, radiological and laparoscopic diagnosis, associated pathologies, operative time, hospital stay, postoperative complications and follow-up. The internal ring was narrowed by approximating IPT to conjoint tendon using 3-0 polypropylene continuous or interrupted suture.

Results In total, 238 IPT repairs were done under general anesthesia in 190 children aged between 1 and 17 years. 7.9% of children had phimosis, and three children had hydrocele. Three patients had undescended testis and another three IPT repairs were done in cases who presented with appendicitis. Contralateral patent processus vaginalis (CPPV) was detected at the time of laparoscopy in 18.3% of cases. Thus far, 166 children had been followed, and no recurrence was observed in any of these 96 of whom have completed more than 3 years after their surgery. However, two patients developed hernia on the contralateral side.

Conclusions Laparoscopy is beneficial to pick up CPPV. Laparoscopic IPT repair for pediatric inguinal hernia is reproducible and safe with the least recurrence reported thus far. However, further follow-up is needed. Moreover, development of contralateral hernia needs to be investigated.

  • gastroenterology
  • pediatrics

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  • Contributors SKN and RP contributed to the planning, data collection, analysis and manuscript preparation of the study. RGGHV, NVP and SR participated in the revision of the manuscript and approval of the final version. CP was involved in the planning of this work, approved the final version and takes the responsibility for the overall content as guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval GEM Hospital ethics committee has approved this study. The ethical committee has approved a waiver of consent given the retrospective nature of the study involving evaluation of maintained data. All efforts were made to keep the individual patient’s identity anonymous.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information. Relevant data have been uploaded as supplementary material. Any further doubts will be clarified if needed.

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