الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
- Inguinal hernia affects 1-5% of mature infants and up to 30% of premature babies.
- Open herniotomy stands for decades as the gold standard treatment method for PIH. However, it has the minimal potential risk of injury to the spermatic vessels and vas deferens, hematoma formation, and inability to evaluate the contralateral internal inguinal ring. Furthermore, the open repair can be challenging in some situations like recurrent or incarcerated hernias, hernias in premature infants, and obese adolescents
- Laparoscopic inguinal hernia repair has challenged conventional surgery over the past 20 years in terms of better cosmetic results, decreased post-operative pain, reduced or comparable operative time, and the ability to evaluate and manage latent contralateral hernias if found but the main concern was always the high recurrence rates.
- LIHR can be classified into two broad categories based on the approach of internal inguinal ring (IIR) repair; intra- or extra-peritoneal with insufficient proof about the ideal technique between them.
- Several needlescopic techniques have been described for extraperitoneal closure of the internal ring to overcome the need for intracorporeal suturing and knotting but they were only limited to peritoneal closure without complete hernia sac disconnection except for 3 reports.
- Hernia sac division is believed to decrease the recurrence rate by producing peritoneal trauma that leads to durable healing.
- With the increasing number of needlescopic procedures in children, needlescopic suturing and knot tying are becoming essential skills for any laparoscopist to master.