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Erschienen in: Surgical Endoscopy 8/2008

01.08.2008 | Review

Minimal access surgery of pediatric inguinal hernias: a review

verfasst von: Ramanathan Saranga Bharathi, Manu Arora, Vasudevan Baskaran

Erschienen in: Surgical Endoscopy | Ausgabe 8/2008

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Abstract

Inguinal hernia is a common problem among children, and herniotomy has been its standard of care. Laparoscopy, which gained a toehold initially in the management of pediatric inguinal hernia (PIH), has managed to steer world opinion against routine contralateral groin exploration by precise detection of contralateral patencies. Besides detection, its ability to repair simultaneously all forms of inguinal hernias (indirect, direct, combined, recurrent, and incarcerated) together with contralateral patencies has cemented its role as a viable alternative to conventional repair. Numerous minimally invasive techniques for addressing PIH have mushroomed in the past two decades. These techniques vary considerably in their approaches to the internal ring (intraperitoneal, extraperitoneal), use of ports (three, two, one), endoscopic instruments (two, one, or none), sutures (absorbable, nonabsorbable), and techniques of knotting (intracorporeal, extracorporeal). In addition to the surgeons’ experience and the merits/limitations of individual techniques, it is the nature of the defect that should govern the choice of technique. The emerging techniques show a trend toward increasing use of extracorporeal knotting and diminishing use of working ports and endoscopic instruments. These favor wider adoption of minimal access surgery in addressing PIH by surgeons, irrespective of their laparoscopic skills and experience. Growing experience, wider adoption, decreasing complications, and increasing advantages favor emergence of minimal access surgery as the gold standard for the treatment of PIH in the future. This article comprehensively reviews the laparoscopic techniques of addressing PIH.
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Metadaten
Titel
Minimal access surgery of pediatric inguinal hernias: a review
verfasst von
Ramanathan Saranga Bharathi
Manu Arora
Vasudevan Baskaran
Publikationsdatum
01.08.2008
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 8/2008
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-008-9846-7

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