TÇCD 2011 29. National Pediatric Surgery Congress and 27. National Congress of The Egyptian Pediatric Surgical Association

Background/purpose:The recurrence of indirect inguinal hernia remains high, vary from less than 0.5% to approximately 4%.Recurrence may be attributed to tearing of a friable sac, a slipped 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.

 

Patient and methods: This prospective study was carried out at the pediatric surgery unit, surgical department, Zagazig University Hospitals, Egyptduring the period from April 2008 to September 2009. The study included 10 boys with recurrent indirect inguinal hernia. Inclusion criteria applied during surgery were: marked adhesions and fibrosis surrounding the cord, distorted anatomy of the inguinal region and patulous internal ring.

 

Results: A total of 10 operations were performed. All patients were male presented with recurrent indirect oblique inguinal hernia; their ages 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. 2 cases had associated patulous internal ring. The operative time ranged from 20-30 minutes. 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, safeand not expensive.

 

 

Background/purpose:The recurrence of indirect inguinal hernia remains high, vary from less than 0.5% to approximately 4%.Recurrence may be attributed to tearing of a friable sac, a slipped 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.

 

Patient and methods: This prospective study was carried out at the pediatric surgery unit, surgical department, Zagazig University Hospitals, Egyptduring the period from April 2008 to September 2009. The study included 10 boys with recurrent indirect inguinal hernia. Inclusion criteria applied during surgery were: marked adhesions and fibrosis surrounding the cord, distorted anatomy of the inguinal region and patulous internal ring.

 

Results: A total of 10 operations were performed. All patients were male presented with recurrent indirect oblique inguinal hernia; their ages 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. 2 cases had associated patulous internal ring. The operative time ranged from 20-30 minutes. 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, safeand not expensive.