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Outcomes following laparoscopic inguinal hernia repair in infants compared with older children
Wonyong Choi1, Nigel J Hall, Massimo Garriboli
1Surgery Unit, Department of Paediatric Surgery, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
Insights
Laparoscopic inguinal hernia repair is safe for infants, with lower recurrence rates than in older children. This approach is beneficial for infants, allowing treatment of bilateral hernias and patent processus vaginalis.
Area of Science:
- Pediatric surgery
- Minimally invasive surgery
Background:
- Laparoscopic inguinal hernia repair indications in children are debated.
- Infants and older children may have different outcomes.
Purpose of the Study:
- Compare clinical features and outcomes of laparoscopic inguinal hernia repair in infants versus older children.
- Evaluate the safety and efficacy of the laparoscopic approach in different pediatric age groups.
Main Methods:
- Retrospective review of 380 patients under 16 years old.
- Comparison of outcomes between infants (≤12 months) and older children (1-15 years).
Main Results:
- Infants had significantly higher rates of bilateral inguinal hernia (61%) and contralateral patent processus vaginalis (PPV) (61%) compared to older children (35%).
- Recurrence rates showed a trend towards being higher in older children (4%) than infants (1%), though not statistically significant (p=0.17).
- Complication rates requiring surgery were similar between the two age groups.
Conclusions:
- Laparoscopic inguinal hernia repair is safe and effective in infants, with acceptable complication and recurrence rates.
- The laparoscopic approach offers advantages in infants by enabling simultaneous management of bilateral hernias and contralateral PPV.
- Further research is needed to fully evaluate outcomes of laparoscopic inguinal hernia repair in older children.
Purpose:
Indications for laparoscopic inguinal hernia repair in infants and children remain controversial. The purpose of this study is to compare clinical features and outcome of laparoscopic inguinal hernia repair in infants with older children.
Methods:
Retrospective single centre review of all patients <16 years of age (n = 380) undergoing laparoscopic inguinal hernia repair over a 5-year period (Jan 2005-Dec 2009). Outcomes were compared between infants (≤ 12 months of age) with older children (1-15 years).
Results:
There was a trend towards higher recurrence rate in older children than in infants (4 % vs. 1 %; p = 0.17). Total complications and complications requiring surgery were similar in both age groups. There was one testicular atrophy in an infant who had an incarcerated inguinal hernia. The incidence of bilateral inguinal hernia and contralateral patent processus vaginalis (PPV) were both significantly higher in infants (total 61 % compared with 35 % in older children).
Conclusions:
Laparoscopic inguinal hernia repair in infants is safe and carries acceptable complication and recurrence rates. The laparoscopic approach may be particularly beneficial in infants since it allows simultaneous closure of a contralateral PPV and bilateral herniae. The outcome of laparoscopic inguinal hernia repair in older children requires further evaluation.