Comparing Postoperative Outcomes Between Laparoscopic-Assisted Percutaneous Internal Ring Suturing and Laparoscopic Intracorporeal Internal Ring Suturing in the Management of Paediatric Inguinal Herniae: A Retrospective Review in Jordan

Published Date: 22nd October 2025

Publication Authors: Shkoukani. ZW

Background
Congenital inguinal herniae are among the most common conditions requiring surgery in children. While laparoscopic repair offers diagnostic and cosmetic advantages over open repair, debate persists regarding the optimal method of internal ring closure. This study compares outcomes of laparoscopic intracorporeal internal ring suturing (LICS) and laparoscopic-assisted percutaneous internal ring suturing (LAPIRS) in a paediatric population.

Methods
We conducted a retrospective cohort study of children who underwent laparoscopic inguinal hernia repair at Jordan University Hospital between January 2019 and December 2020. Demographic data, clinical presentation, operative details, complications, costs, and follow-up outcomes were analysed. Patients undergoing concurrent orchidopexy were excluded.

Results
Of the 221 patients treated for inguinal herniae, 38 met the inclusion criteria (27 males, 11 females; mean age 3 years, range 45 days to 13 years). Seventeen patients (44.7%) underwent LAPIRS and 21 patients (55.3%) underwent LICS. No intraoperative complications occurred. Mean operative time was 45 minutes, with no significant difference between techniques or laterality (p = 0.849). Postoperative morbidity was minimal, with only one case of umbilical disfigurement following LAPIRS. No recurrences or wound infections were observed after a minimum of six months’ follow-up. The median cost was 512 Jordanian Dinars (JOD), equivalent to $720 US dollars, and was unaffected by technique (p = 0.395).

Conclusions
Both LICS and LAPIRS are safe, effective, and cosmetically favourable options for paediatric inguinal hernia repair. Outcomes were comparable, with negligible morbidity and no recurrences. Given potential differences in learning curve, cosmesis, and cost reported internationally, larger prospective studies with longer follow-up are warranted to refine best-practice recommendations.

 

Shkoukani, ZW et al. (2025).Comparing Postoperative Outcomes Between Laparoscopic-Assisted Percutaneous Internal Ring Suturing and Laparoscopic Intracorporeal Internal Ring Suturing in the Management of Paediatric Inguinal Herniae: A Retrospective Review in Jordan. Cureus. 17(10), p.e95131. [Online]. Available at: https://doi.org/10.7759/cureus.95131 [Accessed 30 October 2025]

 

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