Vol. 2, Issue 2, Part A (2025)

Background: Indirect inguinal hernia is one of the most common congenital surgical conditions in children. Bilateral occurrence, though less frequent, demands careful diagnosis and minimally invasive repair. The Percutaneous Internal Ring Suturing (PIRS) method offers a simple, effective alternative to conventional open herniotomy, with fewer complications and faster recovery. 
Case Presentation: A 7-year-old male presented with painless bilateral inguinal swelling that increased on straining and resolved on lying down. Examination confirmed a soft, smooth, reducible swelling with positive cough impulse. Routine blood and serological investigations were normal. Diagnostic laparoscopy confirmed bilateral patent internal rings. The patient underwent laparoscopic PIRS under spinal anaesthesia. The procedure was uneventful, with successful closure of both internal rings using extracorporeal knotting. 
Results: Post-operative recovery was smooth with no complications. The patient was discharged on the next day with advice for supportive care and follow-up. No recurrence or post-operative morbidity was noted at review. 
Conclusion: The PIRS technique is a safe, minimally invasive option for the management of pediatric bilateral indirect inguinal hernia, providing excellent surgical and cosmetic outcomes with minimal operative time and hospital stay.