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Laparoscopic surgery for hernias of the anterior abdominal wall

Surgical interventions for hernias of the anterior abdominal wall are among the most common in pediatric surgical clinics. In newborns, especially premature infants, the frequency of hernias of the anterior abdominal wall is inversely proportional to gestational age and significantly exceeds the rates in older children. The purpose of this study is to compare the results of laparoscopic treatment using the Percutaneous Internal Ring Suturing (PIRS) technique and conventional methods in newborns with hernias of the anterior abdominal wall. Laparoscopic interventions in children older than 2–3 years are gradually becoming the standard of treatment, while in newborns, conventional «open» methods are more often used to treat hernias of the anterior abdominal wall, which is associated with the complexity of the surgical technique, the presence of concomitant pathology and a high anesthetic risk. The question of the timing (early or delayed) of surgical correction of the hernia of the anterior abdominal wall in these patients remains a subject of discussion. According to the results of the study, the duration of PIRS surgery was shorter than with open surgery. The long duration of laparoscopic surgery, which some surgeons note, is explained by the technique of laparoscopic correction – the imposition of an intracorporeal suture requires more time and experience of the surgeon. Furthermore, an inverse relationship was found between the weight of the child and the time of laparoscopic intervention. Laparoscopic treatment of hernias of the anterior abdominal wall with the use of the PIRS method in newborns is not only easier for the surgeon, but also safer for the patient.

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