Potential pitfalls of laparoscopic inguinal hernia repair in children: Case report of an unrecognized sliding hernia and review of other rare complications

Laparoscopic inguinal hernia repair (LIHR) has been shown to be safe and effective in the pediatric population. However, a number of complications exist that are unique to this approach. Here, we provide a review of the literature of rare complications of LIHR and present a case of an extraperitoneal sliding inguinal hernia containing bladder that was unrecognized at the time of laparoscopic repair. While LIHR is associated with low complication rates, our review revealed numerous unique complications of LIHR including bowel strangulation secondary to adhesions, port site hernias, omental evisceration, iliac vein puncture with retroperitoneal hematoma, anesthetic complications and transient or persistent hydrocele. In our experience, we encountered an early postoperative “recurrent” hernia which was found to be a sliding hernia not recognized during LIHR. This was readily recognized and repaired with the open approach. As laparoscopic techniques become increasingly used by pediatric surgeons, it is imperative that both experienced and more novice practitioners of laparoscopy recognize the potential pitfalls unique to laparoscopic repair.