Laparoscopic percutaneous extraperitoneal closure in adolescents and young adults: Potential and pitfalls from a case series.

Abstract

<h4>Introduction</h4>Inguinal hernias can occur at any age. Different surgical procedures are selected for different ages. Generally, hernias are repaired without a mesh in children and with a mesh in adults; however, the surgical approach of choice in the adolescent and young adult (AYA) population is unclear. The aim of this study was to explore the potential extension of the indications for the meshless procedure, laparoscopic percutaneous extraperitoneal closure (LPEC), in the AYA population.<h4>Patients and methods</h4>We retrospectively included individuals aged 16-39 years who underwent laparoscopic inguinal hernia repair in our department from August 2015 to May 2023. We focused on hernias classified under the new Japanese Hernia Society Classification as L1 type. Patient background characteristics and surgical outcomes were collected, and a comparative analysis was conducted between the LPEC group (L group) and the laparoscopic transabdominal preperitoneal repair group (T group).<h4>Results</h4>Laparoscopic inguinal hernia repair was performed in 38 cases (50 sides), including nine patients (12 sides) diagnosed only with L1-type hernias. The L and T groups comprised six (nine sides) and three (three sides) patients, respectively. The operative time was 28 and 67 min in the L and T groups, respectively (P = 0.10). None of the patients experienced recurrence. No significant differences were observed in post-operative pain, post-operative hospital stay or surgical site infections. The median observation period was 1868 days.<h4>Conclusions</h4>LPEC is a viable surgical option for inguinal hernia repair in the AYA population, warranting further exploration for its broader application.