Efficacy of laparoscopic herniorrhaphy for treating incarcerated pediatric inguinal hernia

Purpose Inguinal hernia repair is one of the most common elective surgeries. Most patients present with reducible inguinal bulging; however, in cases of incarcerated inguinal hernia (IIH), an emergency surgery is required. Here, we report the surgical outcomes of a laparoscopic approach for IIH. Methods Laparoscopic herniorrhaphy was performed in 4782 pediatric patients from September 2012 to December 2016 at Damsoyu Hospital, Seoul, Korea. Among them, the surgical outcomes of 164 IIH patients were retrospectively analyzed. Results Incarcerated organs comprised 51 ovaries, 103 intestines, and 10 omentums. The ovary (51/66) and intestine (88/98) were the most common incarcerated organs in females and males, respectively. The intestines, ovaries, and omentums were preserved in most cases. An oophorectomy was performed in one female patient with an unrecovered ischemic ovary, and an orchiectomy was performed in a male patient with ischemic testis because of cord vessel compression caused by intestine incarceration. In male pediatric patients, an age of < 12 months and symptom duration of > 1 week were risk factors for IIH, whereas in female pediatric patients, an age of < 12 months and symptom duration of <= 1 week were risk factors for IIH. Conclusions The intestines and ovaries were the most commonly herniated organs in male and female pediatric patients, respectively. Intracorporeal organ reduction was easily performed with a laparoscopic instrument.