Current Trends in Laparoscopic Hernia Repair in Children

Inguinal hernias are among the most common surgical pathologies in children. In recent years, laparoscopic methods have increasingly been used, with the major advantage being the ability to intraoperatively inspect the contralateral side. Since June 2023, the Department of Pediatric and Adolescent Surgery in Klagenfurt has been offering laparoscopic percutaneous extraperitoneal closure (LPEC) for cases initially presenting with a left-sided hernia, an open contralateral processus vaginalis, an additional umbilical hernia or bilateral inguinal hernias in children over 1 year old as a surgical method. Since January 2024, a nonresorbable FiberStick (TM) suture by Arthrex (Naples, FL, USA) has been standard for inguinal hernia closure. In all, 28 inguinal hernias in 24 patients (female: n = 20, male: n = 4) were treated using LPEC. The average age at the time of surgery was 8.06 +/- 3.2 years (range 3-13 years). The average duration of surgery was 33.3 +/- 11.9 min. A significant reduction in surgery time was achieved through the learning curve. A comparison of patients from 2023 (n = 13) with those who underwent surgery in 2024 (n = 11) showed a significantly shorter operation time (p = 0.008). So far, no local problems due to the suture material have occurred. According to international literature, the LPEC technique proves to be simple and safe. The use of a braided, nonresorbable suture material seems to prevent the described suture complications (suture granuloma) and is significantly easier and faster to introduce due to the stiffened end. However, results need to be monitored over the long term with larger case numbers.