Laparoscopic-assisted repair of femoral hernias in children.

Journal Article (Journal Article)

BACKGROUND: Femoral hernias in children are rare, difficult to diagnose, and require a different treatment approach than the standard indirect inguinal hernia repair. Most femoral hernias in children are still repaired by using a conventional McVay technique. OBJECTIVE: We have developed a simple, effective laparoscopic-assisted femoral hernia repair that avoids opening the inguinal canal in children. PATIENTS AND METHODS: A 5-mm trocar is placed in the umbilicus, and the femoral hernia is visualized intracorporeally via a 30-degree laparoscope. The laparoscope is then passed into the hernia sac, with the visual axis pointing anterior toward the skin. Guided by transillumination, a 1-cm skin incision is made over the hernia sac at the upper thigh; the hernia sac is identified and dissected free from surrounding tissue. The sac is then grasped within the abdomen, inverted, twisted, and an endoscopic tie is placed at its neck. The defect between the medial pectineal and inguinal ligaments is closed externally with an absorbable suture. RESULTS: The described technique was successfully used on 3 boys, each with right femoral hernias (age 4-11; mean = 7). On 6-month follow-up, all patients had excellent cosmetic results with minimal scars and no recurrence. CONCLUSION: Laparoscopic-assisted femoral hernia repair is straightforward, efficient, and avoids dissection of the inguinal canal, thereby circumventing any risk of injury to the vas deferens and spermatic vessels. Although these early results are encouraging, more patients and longer follow-up are necessary to substantiate our technique.

Full Text

Duke Authors

Cited Authors

  • Adibe, OO; Hansen, EN; Seifarth, FG; Burnweit, CA; Muensterer, OJ

Published Date

  • October 2009

Published In

Volume / Issue

  • 19 / 5

Start / End Page

  • 691 - 694

PubMed ID

  • 19694567

Electronic International Standard Serial Number (EISSN)

  • 1557-9034

Digital Object Identifier (DOI)

  • 10.1089/lap.2009.0134

Language

  • eng

Conference Location

  • United States