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.

中文翻译：

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腹腔镜髂耻管修复小儿腹股沟疝复发率极低：一项印度经验

背景 本研究的目的是记录腹腔镜髂耻管 (IPT) 修复小儿腹股沟疝的结果。方法 回顾性分析 2015 年 1 月至 2020 年 1 月期间接受 IPT 修复术的 190 名儿童的住院记录，包括人口学细节、临床、放射学和腹腔镜诊断之间的差异、相关病理、手术时间、住院时间、术后并发症和随访。通过使用 3-0 聚丙烯连续或间断缝合使 IPT 接近联合肌腱来缩小内环。结果 共有 190 名 1 至 17 岁的儿童在全身麻醉下进行了 238 次 IPT 修复。7.9%患儿有包茎，3名患儿有鞘膜积液。三名患者有睾丸未降，另外三名患者在出现阑尾炎的情况下进行了 IPT 修复。18.3% 的病例在腹腔镜检查时发现对侧阴道突未闭 (CPPV)。迄今为止，已对 166 名儿童进行了随访，其中 96 名儿童在手术后 3 年以上完成手术，均未观察到复发。然而，两名患者在对侧出现疝气。结论 腹腔镜有利于摘除CPPV。小儿腹股沟疝的腹腔镜 IPT 修复可重复且安全，迄今为止报告的复发率最低。但是，还需要进一步跟进。此外，需要调查对侧疝的发展。18.3% 的病例在腹腔镜检查时发现对侧阴道突未闭 (CPPV)。迄今为止，已对 166 名儿童进行了随访，其中 96 名儿童在手术后 3 年以上完成手术，均未观察到复发。然而，两名患者在对侧出现疝气。结论 腹腔镜有利于摘除CPPV。小儿腹股沟疝的腹腔镜 IPT 修复可重复且安全，迄今为止报告的复发率最低。但是，还需要进一步跟进。此外，需要调查对侧疝的发展。18.3% 的病例在腹腔镜检查时发现对侧阴道突未闭 (CPPV)。迄今为止，已对 166 名儿童进行了随访，其中 96 名儿童在手术后 3 年以上完成手术，均未观察到复发。然而，两名患者在对侧出现疝气。结论 腹腔镜有利于摘除CPPV。小儿腹股沟疝的腹腔镜 IPT 修复可重复且安全，迄今为止报告的复发率最低。但是，还需要进一步跟进。此外，需要调查对侧疝的发展。两名患者在对侧出现疝气。结论 腹腔镜有利于摘除CPPV。小儿腹股沟疝的腹腔镜 IPT 修复可重复且安全，迄今为止报告的复发率最低。但是，还需要进一步跟进。此外，需要调查对侧疝的发展。两名患者在对侧出现疝气。结论 腹腔镜有利于摘除CPPV。小儿腹股沟疝的腹腔镜 IPT 修复可重复且安全，迄今为止报告的复发率最低。但是，还需要进一步跟进。此外，需要调查对侧疝的发展。