A Comparison Between Two Laparoscopic Techniques in Management of Inguinal Hernias in Pediatrics

A Comparison Between the Percutaneous Internal Ring Suturing (PIRS) Technique and Laparoscopic Intraperitoneal Purse String Suture Sac Closure Technique in Pediatrics

To compare between the use of the percutaneous internal ring suturing (PIRS) technique and the Laparoscopic intraperitoneal purse-string suture sac closure technique. in pediatrics & evaluate the safety, efficacy feasibility ,operative time ,postoperative pain ,recurrence rate of both approaches.

Inguinal hernia repairs (IHRs) are one of the most common procedures performed by pediatric surgeons around the world. Although the open method remains the most common for pediatric IHR, laparoscopic IHR has increased dramatically between 2009 and 2018. Over a dozen different laparoscopic techniques have been developed .With the rise in popularity of laparoscopic IHR, many researchers have set out to examine the differences in efficacy of open IHR compared with various laparoscopic IHR techniques. However, there are few studies directly comparing different laparoscopic techniques. By determining outcome discrepancies among popular laparoscopic techniques for pediatric IHR, we can help improve surgical techniques, postoperative outcomes, and patient satisfaction.The proposed advantages of the laparoscopic approach include visualization of a contralateral PPV, identification of less common (direct, femoral, pantaloon) hernias ,diminished postoperative pain, more rapid return to normal function, and improved cosmesis. Two laparoscopic techniques that have gained popularity among pediatric surgeons in the past decade, the percutaneous internal ring suturing (PIRS) technique and Laparoscopic intraperitoneal purse string suture sac closure technique.

Inclusion Criteria:

• 1. Age 1month to 18 years. 2. Denovo Inguinal Hernias. 3. Uncomplicated Inguinal Hernias.

Exclusion Criteria:

• 1. Complicated Inguinal Hernia 2. Age more than 18 Years 3. cases inwhich laparoscopic surgery is contraindicated 4. cases with collagen disease. 5. Recurrent Inguinal Hernia.