How to prevent recurrence after laparoscopic treatment of pediatric hernia?

  Since the previous publication on the one-hole method for the treatment of pediatric hernia or its success, new improvements have been made in the last six months on the application of laparoscopy for the treatment of pediatric hernia. At present, the application of laparoscopy for the treatment of pediatric hiatal hernia has become a routine method for the treatment of hernia in the pediatric surgical community in China and has gained popularity throughout the country. Therefore, this technique is simple, easy to learn and easy to master, and has become the first procedure for pediatric surgeons to master at the beginning.  However, the popular laparoscopic surgeries nowadays are only high ligation of the hernia sac. There is not even a repair of the inguinal canal. Although this may appear to be “minimally invasive”, it is not appropriate for “large hernias” or “older children”. It is not even as safe as the previous open surgery. According to statistics, the recurrence rate is basically the same after either traditional or laparoscopic hernia surgery.  Last year, after careful study, I improved the laparoscopic treatment of pediatric hernia to prevent recurrence. An internal ring narrowing technique was added to the conventional ligation of the hernia sac. Although this operation was added, the surgical incision remained unchanged, only the suturing technique inside was modified. The operative time was not increased either. The improvement was mainly applied to patients prone to recurrence after hernia surgery, giant hernia, and older children, with satisfactory results. In other words, there is no additional pain and the recurrence rate after surgery is reduced to “zero”. At present, we have successfully completed more than 100 cases and have published articles to promote it.