Laparoscopic inguinal hernia repair in bladder exstrophy, a new modified solution to an old problem: A cohort study. (June 2022)

• Record Type: Journal Article
• Authors: Taher, Heba; Elboraie, Aly; Fares, Ahmed; Tawfiq, Sherifa; Elbarbary, Mohamed; Abdullateef, Khaled S.
• Is Part Of: International journal of surgery case reports. Volume 95(2022)
• Publication Date: 2022-06
• Subjects: Bladder exstrophy -- Inguinal hernia -- Laparoscopic hernia repair; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2022.107252
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Purpose: Open inguinal hernia repair in children with bladder exstrophy is challenging and associated with a high recurrence rate (15%–22%). We report our initial experience with laparoscopic repair of inguinal hernias in five children with repaired bladder exstrophy. This study is the third describing inguinal hernia repair in bladder exstrophy patients using the laparoscopic approach. In this study, we report a different laparoscopic technique. Methods: This retrospective study was performed on data regarding laparoscopic inguinal hernia repair collected over one year (July 2019–2020). We carried out the laparoscopic inguinal hernia repair, closing the internal inguinal ring using a non-resorbable sliding knot suture and incorporating the transversalis fascia for reinforcement, followed by purse-string closure of the peritoneum. Peri- and postoperative outcome parameters, including recurrence rate, were evaluated over a follow-up period of 14 months. Results: A total of seven male patients from July 2019 to 2020 were admitted to our center with a history of repaired bladder exstrophy and reducible inguinal hernias. Two patients had open inguinal hernia repair due to parental preference and five patients had laparoscopic repair. In the laparoscopic group three patients had bilateral inguinal hernias in one of them a metachronous hernia was discovered intraoperstively, and the remaining two patients had unilateral hernias, one on the right side and the other on the left side. All patients in the laparoscopic group had an uneventful recovery and were discharged within 24 h and there were no complications or recurrences during follow-up. Conclusion: Laparoscopic inguinal hernia repair is a better alternative to managing inguinal hernias in children with bladder exstrophy. Highlights: Bladder exstrophy patients have a higher incidence of inguinal hernia compared to the general population. Bladder exstrophy patients have higher reported rate of bilaterality. Bladder exstrophy patients have weaker abdominal wall Few reports about laparoscopic repair. Better anatomical visualization more cosmetically appealing