Abstract
An extremely-low-birth-weight male infant, weighing 840 grams, was treated for a huge scrotal hernia on the left side by traditional surgery consisting of high ligation of the sac and sewing of the internal inguinal ring at 241 days after birth.
He developed a recurrent left inguinal hernia 2 months after the surgery and underwent re-surgery laparoscopically at the age of 1 year 8 months. The left internal inguinal ring showed an enlarged orifice of about 15 mm, and the new hernia sac was shown to be the prolonged processus vaginalis itself. He was treated by the advanced laparoscopic percutaneous extraperitoneal closure method (LPEC with iliopubic tract repair to reinforce the posterior wall of the inguinal canal). He was discharged on postoperative day 1 without any complications, and he has not developed a recurrent hernia 21 months after surgery.
The advanced LPEC method is a highly effective procedure recommended for the treatment of huge inguinal hernias in immature infants.
