Application of Mesh Plug Technique in The Repair of Difficult Cases of Recurrent Indirect Inguinal Hernia in Boys
Keywords: Laparoscopes, recurrent indirect inguinal hernia in children, mesh plug technique.
AbstractBackground/Purpose: The recurrence of indirect inguinal hernia vary from less than 0.5% to approximately 4%. Recurrence may be attributed to tearing of a friable sac, slipping of the ligature at the neck of the sac or failure to ligate the sac high at the internal ring. In boys, re-operations are difficult and require tedious and careful dissection of the dense fibrous tissue resulting from the earlier surgery. There are definite risks of damaging the vas deferens and testicular vessels. The aim of this study is to evaluate the feasibility and outcome of using the mesh plug technique in the repair of certain difficult cases of recurrent indirect inguinal hernia in male infants and children. Materials & Methods: This prospective study was carried out at the pediatric surgery unit, surgical department, Zagazig University Hospitals, Egypt during the period from April 2008 to September 2009. The study included 10 boys with recurrent indirect inguinal hernia. Patients were included in the study during the surgical procedure if they have one of the following inclusion criteria: marked adhesions and fibrosis surrounding the cord, distorted anatomy of the inguinal region and patulous internal ring Results: A total of 10 operations in 10 infants were performed. The patients age ranged from 3 months to 2 years with the mean age (12.1 months). All cases had severe adhesions surrounding the cord structure with marked distortion of the anatomy. Two cases had associated patulous internal ring. The operative time ranged from 20-30 minutes (mean 25 min). The follow- up period ranged from one month to 11 months (mean 5.8 months), during the follow-up period no major complications were noted. Conclusion: The application of mesh plug technique in the repair of difficult cases of recurrent indirect inguinal hernia in boys is easily applicable, safe and not expensive. Index Word: Laparoscopes, recurrent indirect inguinal hernia in children, mesh plug technique.
The journal is the official journal of the: Egyptian Pediatric Surgical Association(EPSA) Mediterranean Association of Pediatric Surgeons (MAPS)\ Pan African Pediatric Surgical Association (PAPSA) Pan Arab Association of Pediatric Surgeons (PAAPS