Clinical trial NCT04266561: Laparoscopic Recurrent Inguinal Hernia Repair
Official title: Laparoscopic Management of Recurrent Inguinal Hernia in Children
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Congenital Hernia
Keywords: Laparoscopy
Recurrent inguinal hernia
Children
Lead sponsor: Al-Azhar University
Sponsor class: OTHER
First posted: 2020-02-12
Enrollment: 42
Sex: ALL
Minimum age (years): 6
Maximum age (years): 4
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: Laparoscopic management of recurrent inguinal hernia in children has been recently introduced in surgical practice. One of the most important advantages of using the laparoscopic approach in cases with recurrent inguinal hernia (RIH) is that it avoids the previous operation site thus avoiding injuries to the vas and vessels \[19\]. Some authors designed a study to compare laparoscopic hernia repairs with classical open repairs for pediatric RIH following the ﬁrst open repair. They stated that avoiding the scarred tissue the former operation area with the laparoscopic approach facilitates the procedure and decreases both the operative time and complication rate. \[5\]. Further, it is as simple as a fresh hernia repair because the time taken for the repair of recurrent hernia laparoscopically was the same as the fresh laparoscopic repair with no added complication \[5,20\]. In laparoscopic surgery, approaching the hernia defect from within the abdomen, makes the area of interest bloodless, and the magnification renders anatomy very clear, making surgery precise \[6,7\].

Detailed description: Abstract: Background: Open repair of recurrent inguinal hernias \[RIH\] in infancy and childhood is difficult and there is definite risk of damaging the vas deferens and testicular vessels. Laparoscopic repair of RIH has the benefit of avoiding the previous operative site. The aim of this study is to present the investigator's experience with laparoscopic repair of RIH either after open or laparoscopic hernia repair with stress on technical refinements to prevent recurrence. Patients and methods: This is a retrospective study of laparoscopic repair of recurrent inguinal hernia. Records of patients that have been subjected to laparoscopic inguinal hernia repair for RIH were reviewed and evaluated. All patients were subjected to laparoscopic repair of 42 recurrent hernial defects. The primary outcome measurements of this study include; operative time. The secondary outcomes include; hydrocele formation, iatrogenic ascent of the testis and testicular atrophy.

Eligibility criteria: Inclusion Criteria:

* Recurrent inguinal hernia

Exclusion Criteria:

* complicated inguinal hernia

Primary outcomes:
measure: Operative time
timeFrame: From the incision time to the closure of the wound
Secondary outcomes:
measure: Hydrocele formation
timeFrame: one month postoperatively
measure: Testicular atrophy
timeFrame: three months postoperatively
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Al-Housain University Hospital
Study officials:
affiliation: Al-Azhar University, Nasr City, Cairo, Egypt
name: Rafik Shalaby, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Shalaby R, Ismail M, Dorgham A, Hefny K, Alsaied G, Gabr K, Abdelaziz M. Laparoscopic hernia repair in infancy and childhood: evaluation of 2 different techniques. J Pediatr Surg. 2010 Nov;45(11):2210-6. doi: 10.1016/j.jpedsurg.2010.07.004.
citation: Shalaby RY, Fawy M, Soliman SM, Dorgham A. A new simplified technique for needlescopic inguinal herniorrhaphy in children. J Pediatr Surg. 2006 Apr;41(4):863-7. doi: 10.1016/j.jpedsurg.2005.12.042.
citation: Shalaby R, Ibrahem R, Shahin M, Yehya A, Abdalrazek M, Alsayaad I, Shouker MA. Laparoscopic Hernia Repair versus Open Herniotomy in Children: A Controlled Randomized Study. Minim Invasive Surg. 2012;2012:484135. doi: 10.1155/2012/484135. Epub 2012 Dec 27.
citation: Shalaby R, Desoky A. Needlescopic inguinal hernia repair in children. Pediatr Surg Int. 2002 Mar;18(2-3):153-6. doi: 10.1007/s003830100655.