Vol. 9, Issue 1, Part C (2025)

Background: Pediatric inguinal hernia (PIH) is a common surgical condition in children, affecting 0.8% to 4.4% of full-term infants. The primary cause is a congenital patent processus vaginalis (PPV). Laparoscopy has emerged as an alternative approach to traditional inguinal hernia repair. Aim of the Study to compare laparoscopic inguinal hernia repair (LIHR) with open inguinal herniotomy (OIHR) regarding operative time, hospital stay, surgical site infection, recurrence rate, iatrogenic ascent of the testis, and testicular atrophy. 
Patients and Methods: a prospective study was conducted on children aged 2–14 years who underwent inguinal hernia repair at Children Welfare Teaching Hospital, Baghdad Medical City, from June 2021 to June 2022. A total of 115 children were randomized into two groups: OIHR (75 patients) and LIHR (40 patients), performed by the same surgical team. Outcomes, including operative time, hospital stay, complications, and contralateral PPV (CPPV) detection, were analyzed. 
Results: the mean age was 7.7±3.3 years in the OIHR group and 5.5±2.9 years in the LIHR group. Males comprised 73.3% in OIHR and 60% in LIHR. Bilateral hernias were more common in LIHR (17.5% preoperatively, 25% postoperatively). Operative time was longer in LIHR (46.8±6.9 minutes) than OIHR (30.7±4.7 minutes). Hospital stays of two days occurred in 18.7% of OIHR patients versus 2.5% in LIHR. Postoperative complications occurred in 6.7% of OIHR and 5% of LIHR. No testicular atrophy was reported in either group. 
Conclusion: LIHR is safe, provides enhanced anatomical visualization, and allows bilateral orifice evaluation and contralateral hernia repair.