Laparoscopic correction of relapse inguinal hernia in children
DOI:
https://doi.org/10.11603/2414-4533.2016.4.7184Abstract
Repeated surgery for inguinal hernia recurrence in children performed by traditional access to the inguinal area, always has complications such as presence of rough scars and disruption to the normal anatomical relationships between organs and tissues of inguinal area. High traumatic re-intervention, also has complications such as presence of adhesions between elements of cremasteric muscle and spermatic cord in boys and significant spikes in the area round ligament of the uterus in girls, leading to a gross disorder of all levels of drainage testes in boys and development of vascularization ovarian disorders in girls. These factors encourage pediatric surgeons to find new, less traumatic and highly efficient methods of surgical treatment of recurrent inguinal hernias in children. These objectives are fully satisfied by our improved method of laparoscopic correction of recurrent inguinal hernias with conducting intraoperative ultrasound control of inguinal area in the intervention part. During the period from 2013 to 2015 in the Surgical Department of “Specialized Clinical Medical Centre of a Mother and a Child by Prof. M. Ph. Rudniev” in Dnipro, Ukraine there were performed 18 laparoscopic interventions for recurrent inguinal hernias in children whose first intervention was performed by traditional access to the inguinal area. All the children were under the age of 3 years. While analyzing the cases of relapse of inguinal hernias we found that relapses appear in young children, and more often after surgery on strangulated inguinal hernias, which are operated by traditional methods. Thus, our proposed method of laparoscopic correction of recurrent inguinal hernias allows eliminating the inguinal hernia sac without further injury of inguinal canal structures that are in a state of rumen process that came after previous surgery in the inguinal area. In addition, good cosmetic effect of repeated surgery prevents the formation of adhesions and postoperative coarse scars. In the course of our work, it is proved that among the measures aimed at the restoration of the drainage of the testes in disorder of the obliteration of the vaginal process of peritoneum in boys and to preserve the vascularization of the ovary in girls is dominated: timely re-surgical treatment of children, the use of pathogenesis reasonable way of surgical correction pathology at deep inguinal ring using modern laparoscopic technique.
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