Laparoscopic inguinal hernia repair by modified peritoneal leaflet closure: Description and initial results in children

Laparoscopic herniorrhaphy using a peritoneal leaflet closure technique is safe and effective when used in infants and children to close an indirect hernia (i.e. patent processus vaginalis). No intraoperative complications occurred in this cohort and success rate was 97%.316Figure. Intraoperative images of modified peritoneal leaflet closure technique in a right-sided inguinal hernia. (A) An incision is made circumferentially in the peri-orificial peritoneum just proximal to the internal inguinal ring (dashed white line). Care must be taken to identify and preserve the vas deferens (yellow arrow) and testicular vessels (red arrow) during this step. (B) Image immediately after dissection and development of the peritoneal leaflets. (C) The peritoneal leaflets are then closed together over the internal inguinal ring with a running, non-absorbable barbed suture.