Dvorakevych A. Comparative characteristic of conventional and mini-invasive treatment of inguinal hernia in children

The study based on the results of treatment of the 1128 children that were operated during 2010-2015 years in the Lviv regional children's clinical hospital "OHMATDYT". The main group complained 389 patients that were operated using the laparoscopic method of percutaneous internal ring suturing (PIRS) and 739 children, which were operated with the conventional methods of hernioplasty, included in the control group. The comparison results of open and laparoscopic surgery in patients over one year showed advantages of the PIRS method. The laparoscopic repair of inguinal hernia in these patients accompanied by the less often cases of recurrence (0.7% vs. 2.2%) and development of the surgical site infection (1.1% vs. 2.2%). With the aim for the further improving results of laparoscopic repair, the modification of conventional PIRS - the double PIRS was applied. The advantages of double PIRS consist in more tightly closure of internal inguinal ring and more quickly and ergonomic intracorporeal looping of internal inguinal ring. The comparative analysis results of the open and laparoscopic repair in patients with the incarcerated, and recurrent hernia also confirmed the advantages of mini-invasive surgery - decrease of operative time, frequency of recurrences and total number of complications as in the early postoperative period, as follow-up. The histopathology examination of biopsies from patent processus vaginalis revealed in 77.8% of patients morphological changes that typical for the non-differentiated dysplasia of connective tissue and may be the morphological factors for the it's obliteration disorders. Thus, the results of our study confirmed that the PIRS method and its modification (double PIRS) due to its simplicity, safety and efficiency is the real alternative to the open repair of inguinal hernia in children independently of its age.