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S20-8
(P)
PERCUTANEOUS INTERNAL RING SUTURING IS A SAFE AND EFFECTIVE METHOD
FOR TREATMENT OF PEDIATRIC INGUINAL HERNIA
David Terence THOMAS
1
, Kamil Basar GOCMEN
1
, Serkan TULGAR
2
and Ibrahim BOGA
2
1) Pendik State Hospital, Pediatric Surgery, Istanbul, TURKEY - 2) Pendik State Hospital, Anesthesiology and
Reanimation, Istanbul, TURKEY
PURPOSE
First described in 2006, percutaneous internal ring suturing (PIRS) is a method of laparoscopic herniorrhaphy, providing
a minimal invasive method for closure of the internal inguinal ring under the control of a telescope placed in the
umbilicus. In this study we present our experience and results of pediatric inguinal hernia repair using PIRS technique.
MATERIAL AND METHODS
All patients undergoing herniorrhaphy for inguinal hernia or communicating hyroceles at our institute from June 2013 -
March 2015 underwent laparoscopic PIRS and were prospectively included in this study. Patients age, gender, surgery
times plus operative and follow-up findings were noted.
RESULTS
Two-hundred and thirteen patients (134 male, 79 female, average age 5.6y and weight 20.4kg) undergoing PIRS were
included in this study. A total of 248 PIRS were performed. Preoperative findings/history demonstrated patent processus
vaginalis on right side in 113 (53.1%), left side in 75 (35.2%) and bilateral in 25 (11.7%) patients. Intraoperatively, 35
patients (16.4%) were found to have contralateral hernia that was repaired during the same session. Average surgical
time for unilateral PIRS was 14.3m and bilateral PIRS was 20.4m. During average follow-up of 5.6m, complications were
seen in 3 patients (1.4%, keloid scar formation, omental evisseration and postoperative hydrocele). Recurrence was
observed in 3 patients (1.4%). Apart from one patient that developed keloid scar of the umbilical incision, cosmetic
results were excellent.
CONCLUSIONS
PIRS is a safe, fast and effective method for herniorrhaphy in children with inguinal hernia or communicating hydroceles
with excellent results.