A new laparoscopic technique for pediatric epigastric hernia repair: a feasibility case series.

Abstract

This report is a novel laparoscopic technique for pediatric epigastric hernia repair using 3-mm instruments and intracorporeal barbed sutures. A series of three children aged 3 to 6 years presented with a visible or palpable midline bulge, with or without intermittent pain. All had solitary epigastric defects confirmed by ultrasound. Laparoscopic repair was performed via three left lateral abdominal 3-mm ports, avoiding visible central incisions. Preperitoneal fat was reduced or excised, and the fascial defect was closed with a running barbed suture without knots. All patients were discharged the same day without complications. Follow-up up to 2 years revealed no recurrences and excellent cosmetic outcomes, with nearly invisible scars and high parental satisfaction. This technique offers a safe, effective, and cosmetically superior alternative to traditional open repair, especially in small children with central abdominal wall defects.