Laparoscopic Extracorporeal Ligation of the Internal Inguinal Ring by a Spinal Needle: a Simple Method of Hernia Repair in Children

Laparoscopic repair has emerged recently as an alternative technique for hernia repair in children. Various methods of repair have been described. Basic principle is to close the internal inguinal ring either by intracorporeal or by extracorporeal suturing. The objective of this study is to describe and evaluate the outcome of a simple technique of internal ring closure by a spinal needle. A total of 43 hernias in 41 patients were repaired. A prolene thread was passed percutaneously around the internal inguinal ring by threading it though a spinal needle under laparoscopic control. The suture is then tied extracorporeally in the subcutaneous plane. There were 15 female and 26 male patients in the age group of 1½ to 12 years. Right-sided hernia was present in 31 cases and left-sided hernia in eight cases, and two cases had bilateral hernia. All cases were repaired successfully. There was no intraoperative or postoperative complication. This new technique has all the advantages of laparoscopic hernia repair in children (minimally invasive, less pain, less complication, and cosmesis). In addition, the method is simple and it does not need any special equipment or advanced laparoscopic skill.