Experimental Study Investigating the Feasibility of a New Method for Laparoscopic Indirect Inguinal Hernia Repair

Abstract

With the progress in laparoscopic techniques in recent years, there is an increased interest in laparoscopic hernia repair. The laparoscopic indirect inguinal hernia repair with simple closure of the internal ring seems feasible in childhood inguinal hernia repair; however, this technique carries the risk of postoperative patent processus vaginalis. In this study we investigated the possibility of avoidance of this complication by chemical obliteration of processus vaginalis with 6010 iodine solution in rats. The study population was comprised of three groups: simple suture of the internal ring, iodine application plus simple suture of the internal ring, and iodine application alone. While processus vaginalis was anatomically closed in 75% of the rats in the iodine plus simple suture of the internal ring group, it was closed in 10% of the iodine application alone group and was not closed in the simple suture of the internal ring alone group. No histopathologic injuries to the testis or cord were detected attributable to iodine. Our study showed that simple suture of the internal ring is not sufficient for hernia repair. Laparoscopic chemical agent application in addition to simple suture of the internal ring may be beneficial for successful laparoscopic indirect inguinal hernia repair in children.

Key Words:

• herniography
• inguinal hernia
• laparoscopy