Long-term follow-up of pediatric open and laparoscopic inguinal hernia repair

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Hernia Repair

Background:

• Pediatric laparoscopic inguinal hernia repair is not widely accepted.
• Comparison between open and laparoscopic techniques is crucial for surgical decision-making.

Purpose of the Study:

• To compare the outcomes of open versus laparoscopic inguinal hernia repair in children.
• To evaluate ipsilateral reoperation rates, contralateral repair rates, operative time, and complications.

Main Methods:

• Retrospective cohort study of 1697 children (0-14 years) undergoing inguinal hernia repair from 2010-2016.
• Classification into five groups: open unilateral without exploration, open unilateral with contralateral exploration, open bilateral, laparoscopic unilateral, and laparoscopic bilateral repair.
• Outcomes assessed included ipsilateral reoperation, metachronous contralateral repair, incision time, and complications.

Main Results:

• Laparoscopic and open approaches showed similar low ipsilateral reoperation rates (0.3% vs 0.8%) and comparable complication rates (1.11% vs 0.43%).
• Metachronous contralateral repair rates were significantly lower in patients undergoing laparoscopic unilateral repair (0.9%) or open repair with contralateral exploration (0.7%) compared to open unilateral repair without exploration (3.8%).

Conclusions:

• Both laparoscopic and open inguinal hernia repair techniques are safe and effective in children.
• Laparoscopic contralateral exploration during unilateral inguinal hernia repair significantly reduces the incidence of metachronous contralateral repair, making it a valuable approach.