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Published on: November 30, 2010
Inguinal herniotomy with the Mitchell-Banks' technique is safe in older children
Erdal Türk1, Mehmet Erdal Memetoglu2, Yesim Edirne2
1Department of Pediatric Surgery, Izmir University, Faculty of Medicine, Izmir, Turkey.
Insights
The Mitchell-Banks technique and Ferguson hernioplasty show similar recurrence and complication rates for inguinal hernia repair in boys over two years old. Both methods are safe and effective for pediatric inguinal hernia treatment.
Area of Science:
- Pediatric Surgery
- Surgical Techniques
- Hernia Repair
Background:
- Inguinal hernia repair in children over two years old often involves opening the inguinal canal.
- Smaller children typically undergo superficial herniotomy, such as the Mitchell-Banks technique (MBT).
Purpose of the Study:
- To compare the Ferguson hernioplasty (FH) and Mitchell-Banks technique (MBT) for inguinal hernia repair in older boys.
- Evaluate differences in recurrence and complication rates between the two surgical methods.
Main Methods:
- Retrospective review of medical records for children aged two years and older who underwent inguinal herniotomy between 1997 and 2012.
- Analysis of 4520 procedures, comparing FH (opening inguinal canal) with MBT (superficial to external ring).
Main Results:
- Total complication rates were comparable: 2.3% for FH and 2.9% for MBT (P>.05).
- Early complications (wound infection, scrotal edema, hematoma) and late complications (recurrence, undescended testis, testicular atrophy) showed no significant differences between groups.
- Recurrence rates were 0.12% for FH and 0.12% for MBT.
Conclusions:
- The Mitchell-Banks technique is a safe and simple procedure for inguinal hernia repair in older boys.
- Both FH and MBT demonstrate comparable safety and efficacy profiles in this pediatric population.
Purpose:
There is a tendency for the majority of surgeons to open the inguinal canal in children over two years old when performing inguinal hernia repair. On the other hand, in small children, most surgeons perform the herniotomy superficially to the external ring, as in Mitchell-Banks' technique (MBT). Our aim was to compare the Ferguson hernioplasty (FH) and Mitchell-Banks' technique in terms of recurrence and complication rates in older children.
Methods:
We retrospectively reviewed the office medical records of children who were at least two years old and who underwent a herniotomy procedure for inguinal hernia between 1997 and 2012.
Results:
The 4520 inguinal herniotomy procedures in boys who were over two years old were included in this study. Of these cases, 1607 cases (40.2%) were operated on by a FH with opening the inguinal canal, and 2388 cases (59.8%) by MBT superficially to the external ring. The median ages were 5.1 years (range, 2.0-16.2) in the FH group and 4.6 years (2.0-14.6) in the MBT group. The total complication rates were 2.3% in the FH group and 2.9% in the MBT group (P>.05). Early complications such as wound infection, scrotal edema, and hematoma were seen in 13 (0.8%), 15 (1%), and 10 (0.6%) in the FH group, and 12 (0.5%), 18 (0.7%), and 15 (0.6%) in the MBT group, respectively (P>.05). Late complications such as recurrence, trapped undescended testis, and testicular atrophy were seen in 2 (0.12%), 1 (0.06%), and 2 (0.12%) in the FH group, and 3 (0.12%), 1 (0.04%), and 2 (0.08%) in the MBT group (P>.05).
Conclusion:
The Mitchell-Banks technique is a simple and safe procedure in older boys.
