A Review of Laparoscopic Percutaneous Extra Peritoneal Closure (LPEC) for the Treatment of Pediatric Inguinal Hernia

Since laparoscopic percutaneous extra peritoneal closure (LPEC) was introduced as a treatment for pediatric inguinal hernia in 2000, the procedure has been the most common surgical technique for repairing pediatric inguinal hernia in Japan. Research date shows that LPEC and conventional open repair have equivalent rates of recurrence and of postoperative complications. In addition, if contra lateral patent processes vaginalis (CPPV) is confirmed, prophylactic contra lateral LPEC is useful for preventing metachronous contra lateral hernia (MCH). Recently, reduced-port surgery has been adopted throughout the laparoscopic surgery field. Two improved LPEC techniques, known as single-incision laparoscopic percutaneous extra peritoneal closure (SILPEC) and percutaneous internal ring surgery, are not significantly different from LPEC in operating time, intra operative complications or recurrence. Finally, the learning curve for surgical residents to perform the LPEC technique safely without supervision is more than 30 cases. Thus LPEC is an acceptable alternative to conventional open repair.