Laparoscopic transection and partial resection of hernia sac in the treatment of indirect inguinal hernia: A preliminary observation.

Introduction: This study aimed to investigate the feasibility of applying laparoscopic transection and partial resection of hernia sac in the treatment of indirect inguinal hernia in children.

Patients and methods: From December 2017 to November 2018, we recruited 20 children, who were aged 1-6 years old, with indirect inguinal hernia. At the time of admission, the participants had already developed an indirect inguinal hernia for 6 months to 1 year. A simple transection and partial resection of hernia sac was performed at the internal ring on each of the recruited children. The procedure was conducted under laparoscopy. Two 5-mm trocars were placed on either side of the umbilicus, one for the camera and the other for a surgical instrument. Another trocar was placed on the right abdomen. Laparoscopic camera curved forceps, and scissors were placed. Along the unclosed internal ring, the peritoneum was cut in a circular fashion to transect the hernia sac and dissociate it from the distal end. About 1-2 cm of the hernia sac was resected.

Results: The operation was successfully completed in all 20 cases, who did not experience any complications, such as the absence of spermatic cord, vas deferens injury, scrotal swelling and incision infection. The children were discharged 1 day after the operation. In the post-operative follow-up for the first 3-4 years, recurrence and testicular atrophy did not occur in the study participants.

Conclusion: The short-term results obtained from this study showed that the application of laparoscopic transection and partial resection of hernia sac in the treatment of indirect inguinal hernia is feasible. Long-term results and further observation are needed for validation.