Laparoscopic hernia repair in children by the hook method: a single-center series of 433 consecutive patients

Background: The relatively high recurrence rate reported in laparoscopic hernia repair in children using intracorporeal suturing technique remains a concern. We aimed to investigate the effectiveness of the hook method during hernia repair that allows extraperitoneal passage of suture to close the hernia sac without creating any tension or skip areas and does not require laparoscopic suturing skills. Methods: A retrospective review was conducted on 433 consecutive children who underwent laparoscopic hernia repair using the hook method by I of 4 surgeons from July 2004 to June 2007. Results: A total of 572 successful laparoscopic hernia repairs were performed among the 433 children with an age range of I week to 15 years (mean = 56 months). Conversion rate was 1.04%. Contralateral patent processus vaginalis was found in 26.8%. Mean operating time was 23.8 and 40.2 minutes for unilateral and bilateral repair, respectively. At a median follow-up of 20 months, there were 2 recurrences (0.35%), 2 hydroceles, I ascending testis, and I instance of testicular atrophy. No serious complications were associated with the procedure. Conclusions: Medium-term results suggest that laparoscopic hernia repair with the hook method is a sound alternative to open hemiotomy in children. (C) 2009 Elsevier Inc. All rights reserved.