# Laparoscopic-assisted repair of inguinal undescended testis with concurrent incarcerated hernia in children: a single-center experience

## TL;DR

This study evaluates a laparoscopic method for treating undescended testis and hernia in children, showing it is safe and reduces the need for open surgery.

## Contribution

The study introduces a laparoscopic-assisted procedure for concurrent hernia and undescended testis repair in children.

## Key findings

- The LAHRTO procedure had a 71.4% success rate in early-stage cases without complications like infections or hernia recurrence.
- Five cases of contralateral patent processus vaginalis were identified and managed during the same surgery.
- Two testes showed partial atrophy during follow-up, but no testicular retractions or hernia recurrences were observed.

## Abstract

We report clinical, operative, and outcome data for laparoscopic- assisted minimal procedure for treating unilateral inguinal undescended testis (UDT) with concurrent ipsilateral incarcerated hernia in children.

Early-stage cases were defined as those presenting within 24 h of symptom onset with stable vital signs and absence of peritonitis, intestinal necrosis, or testicular necrosis. A retrospective analysis was conducted on patients undergoing laparoscopic-assisted hernia repair and trans-scrotal orchidopexy (LAHRTO) procedure.

A total of 14 cases were enrolled (Left, n = 4; Right, n = 10). Incarcerated hernia contents comprised viable omentum or bowel, without necrosis or intestinal perforation. Ten cases achieved successful laparoscopic reduction, while four cases required conversion to open inguinal incision due to failed reduction. All the testes were preserved and underwent the LAHRTO procedure except for those that converted. Notably, five cases of contralateral patent processus vaginalis (PPV) were identified, allowing for synchronous closure during surgery. The average operation time was (46.8 ± 5.2) min, resulting in a success rate of 71.4% (10/14). At 16–24 months of follow-up, two testes showed partial atrophy. No wound infections, hernia recurrences, or testicular retractions were observed.

Our initial findings suggest that the LAHRTO procedure appears safe and feasible for early-stage inguinal UDT with concurrent incarcerated hernia in children, reducing inguinal incisions and enabling concurrent contralateral PPV management. A larger number of cases with longer follow-up is needed to validate the results of the current study in an evidence-based manner.