To investigate the laparoscopic surgical approach and safety of direct inguinal hernia in children.

A retrospective analysis was conducted on the children with direct inguinal hernia who underwent laparoscopy in the First People's Hospital of Foshan Hospital from July 2010 to January 2019. According to the method of operation, they were divided into the group A (high ligation of hernial sac) and the group B (high ligation of hernial sac and covering pubic foramen with medial umbilical ligament).

Among 6157 patients of inguinal hernia, 32 cases of pediatric direct hernia surgery were completed. There were 14 patients in group A and 18 patients in group B. There were no significant differences in operation time, intraoperative blood loss and hospitalization time between the two groups (P>0.05). In group A, there were 3 cases of recurrence in 3 months, 1 patient in 6 months and 6 patients in 1 year. The recurrence rate was 71.4%. In group B, only 1 patient developed recurrence in 1 year. The recurrence rate was 5.6%, and the recurrence rate were significantly lower than that of group A (P<0.05). There were no other complications occurred in either group.

The operative method of laparoscopic high ligation of hernia sac was not ideal for direct inguinal hernia of children, the recurrence rate was high. Covering triangle of direct hernia with ipsilateral medial umbilical ligament can increase the strength of the abdominal wall. It can significantly reduce the recurrence rate, which was a safe, effective and simple method of laparoscopy.