Abstract:

There are several technical options of laparoscopic inguinal hernia repair in adolescent patients, including five major approaches: (1) Laparoscopic percutaneous extraperitoneal closure, with the ligature knot buried in the subcutaneous tissue. According to the operating procedure, it can be divided into two techniques: one-step method and two-step method. (2) Laparoscopic purse-string suture of the hernia sac. This method leaves the ligature knot in the abdominal cavity, which can be divided into two techniques: single-port approach of intraabdominal suture combined with external knotting, and two-port approach of totally intracorporeal knotting. (3) Modified laparoscopic flip-flap hernioplasty. During the approach, the anteriolateral border of the hernia sac is divided, and the sac is peeled and removed appropriately. Then the lateral and medial edge of the internal ring are sewn together. (4) Medical umbilical ligament covering the internal ring as reinforcement of laparoscopic high ligation herniorrhaphy. For younger adolescents (10-14 years of age) meet the Chinese Type Ⅱ criteria, the medial umbilical ligament can be sewn directly to the lateral edge to cover and reinforce the internal ring. For elder adolescents (14-19 years of age) and those meet the Chinese Type Ⅳ criteria, a peritoneal flap is made using the medial umbilical ligament to cover and reinforce the internal ring. (5) Transabdominal preperitoneal or totally extraperitoneal laparoscopic techniques using biological mesh. Laparoscopic treatment is an option of adolescent inguinal hernia repair with attractive future, but without widespread acceptance.

Key words: Hernia, inguinal, Adolescent, Laparoscopy, Surgery, Review