A prospective cohort study on the laparoscopic repair of inguinal hernia in cases of ventriculoperitoneal shunt for hydrocephalus

Introduction Ventriculoperitoneal shunt (VPS) is still the most common surgical procedure performed in management of hydrocephalus in pediatric-age group to drain cerebrospinal fluid from the ventricles toward the peritoneal cavity aiming to decrease the intracranial pressure. The reported incidence of inguinoscrotal complications may be as high as 10-20% in patients with VPS. Some concerns still present about the use of laparoscopy in children with noncomplicated VPS to avoid shunt-related complications. Aim To evaluate the efficiency of laparoscopy in management of pediatric inguinal hernia in patients with noncomplicated VPS. Our primary outcomes were shunt preservation, recurrence, and incidence of postoperative complications, including shunt blockage, infection, and/or signs of increased intracranial tension. Patients and methods This prospective study included 12 children with pediatric inguinal hernias who were operated for VPS for management of hydrocephalus, admitted, and managed in Pediatric Surgery Unit, Tanta University Hospital, from July 2019 to July 2021. All included infants were followed up for 6 months. Results Our study included 12 patients with pediatric inguinal hernia who were operated with VPS for the treatment of hydrocephalus with a mean age of 30.5 months. Seven (58.3%) cases were recurrent. Operative time ranged between 18 and 48 min with mean of 28.75 min. All patients were discharged after 24 h of surgery. No meningitis or signs of increased intracranial tension were detected early postoperatively, also, there was no recurrence or port-site hernias were detected 6 months postoperatively. Conclusion Laparoscopic muscular arch repair with peritoneal closure of pediatric inguinal hernia in patients with noncomplicated VPS is feasible, safe, and provides minimally invasive approach with excellent results, especially in recurrent cases with better cosmesis.