Abstract

Aim: Inguinal hernia repair is one of the most frequently performed operative procedures in children. The golden standard of treatment for this disorder is an open surgical approach through a groin incision. However, laparoscopic inguinal hernia repair in children has also become popular in recent years. Laparoscopic herniorrhaphy in pediatric surgery is usually performed through three ports in the abdominal wall with intraperitoneal suturing. Here we are presenting the technical details of the PIRS operation described by Patkpwsky that requires only one port.

Materials and Methods: The procedure is carried out under general anesthesia using endotracheal or laryngeal mask. Pneumoperitoneum is created by an open technique. Under laparoscopic-guided vision an injection needle with a non- absorbable thread inside the barrel of the needle is placed through the abdominal wall into the peritoneal cavity. By moving the injection needle, the thread passes under the peritoneum around the entrance into the hernia sac. The knot which wraps around the neck of the hernia is tied outside the abdomen, and the entrance of the inguinal canal is closed.

Conclusion: The advantages of this technique include the use of only one umbilical port, resulting in short operative times, relative simplicity of the procedure and excellent cosmetic results with almost invisible surgical wound scars. According to our experience, percutaneous PIRS operation should be considered as a treatment alternative to open surgery and other laparoscopic procedures.