Different Laparoscopic Techniques for Management of Congenital Inguinal Hernia in Pediatrics

Study Overview
=================
Brief Summary
-----------------
Comparison between multiple approaches of laparoscopic hernia ( percutaneous assisted laparoscopic hernia, purse string closure of hernial sac, total dissection of hernial sac).

Detailed Description
-----------------
In pediatric age, indirect inguinal hernia represents more than 95% of the hernial disease. It is a congenital type, in contrast with adulthood in which acquired forms are more frequently found. Inguinal hernia repair is one of the most frequently performed surgical procedure in infants and young children. Laparoscopic hernia repair in infancy and childhood is still debatable. There are many techniques available for laparoscopic hernia repair in pediatrics. Laparoscopic hernial repair is increasingly adopted even for neonates and has achieved a high success rate with low recurrence rate with long-term follow-up. The main advantages of laparoscopy are no incision of the fascia, exploration of the other side in case of bilateral hernia, and visualization and safeguarding of the vas deferens and the spermatic vessels. Moreover, it is advantageous over open technique in case of recurrent hernia. Different modalities of techniques have been used for repair such as needlescopic disconnection of hernia sac, flip flap technique, muscular arch repair, and ring closure.

Official Title
-----------------
Different Laparoscopic Techniques for Management of Congenital Inguinal Hernia in Pediatrics

Conditions
-----------------
Congenital Inguinal Hernia

Intervention / Treatment
-----------------
* Procedure: Laparoscopic assisted hernia
* Procedure: Laparoscopic hernia by purse string closure
* Procedure: Total laparoscopic dissection of hernial sac


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: patients in the age limit with congenital inguinal hernia Exclusion Criteria: recurrent hernias cases inwhich laparoscopic surgery is contraindicated cases with collagen defect diseases

Ages Eligible for Study
-----------------
Minimum Age: 1 Month
Maximum Age: 5 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Percutaneous assisted laparoscopic hernia<br> | Procedure: Laparoscopic assisted hernia<br>* Percutaneous assisted laparoscopic hernia<br>|
| Active Comparator: Laparoscopic Purse string closure of hernial sac<br> | Procedure: Laparoscopic hernia by purse string closure<br>* Laparoscopic purse string closure of hernial sac<br>|
| Active Comparator: Laparoscopic Total dissection of hernial sac<br> | Procedure: Total laparoscopic dissection of hernial sac<br>* Total laparoscopic dissection of hernial sac<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Operative time | Comparison between operative time in the three approaches | 4 months | 
| Early recurrence | Comparison between early recurrence of hernia in the three approaches | 4 months | 
| Post operative pain duration | Comparison between post operative pain duration between the three approaches | 4 months |