ArticlePediatric surgery international2022
Direct ligation of the internal ring incorporating the medial umbilical ligament (DIRIM): a new modification for laparoscopic percutaneous inguinal hernia repair in children.
Article in Pediatric surgery international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Single port laparoscopic umbilical fold reinforcement surgery reduces the postoperative recurrence rate of pediatric giant inguinal hernia.Scientific reports · 2025Article
- Causes of recurrence of paediatric inguinal hernia after single-port laparoscopic closure.Pediatric surgery international · 2024Article
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Authors and funding
4 authors.
Funding
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Abstract
objectiveLaparoscopic hernia repair has not gained widespread acceptance. Relatively high recurrence rate is a major cause. To reduce recurrence, we report a novel modification of laparoscopic percutaneous inguinal hernia repair in children by a retrospective cohort study. MATERIAL AND
methodsBetween February 2020 and August 2021, children who underwent a laparoscopic percutaneous inguinal hernia repair with our modified technique were retrospectively evaluated. In our modification, we included the medial inguinal ligament in the Direct ligation of the internal ring incorporating the medial umbilical ligament (DIRIM): a new modification for laparoscopic percutaneous inguinal hernia repair in children. By doing so, the medial ligament is expected to act like a flep that reinforces the repair and prevent the peritoneal shearing and migration of the ligature.
resultsIn total, 35 children were enrolled in the study with 23 boys and 12 girls. Right inguinal hernia (n = 23) was more common than left hernia (n = 10), while bilateral cases (n = 2) were less common. The median age of the patients was 38 months and median operative time was 30 min. An extraperitoneal hematoma was encountered in one patient that did not affect the postoperative course. No other intraoperative complication was encountered. No recurrence was observed during a median follow-up of 1 month.
conclusionsOur modification of laparoscopic percutaneous hernia repair is a simple and reproducible technique that may have a place in the armamentarium of a pediatric surgeons. LEVEL OF EVIDENCE: IV.
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