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Single-incision approach for bilateral inguinal hernia repair in children: A retrospective study
Insights
Single-incision bilateral inguinal herniorrhaphy (SBIH) is a safe and effective new surgical approach for pediatric patients with bilateral inguinal hernias. This method offers comparable outcomes to laparoscopic bilateral inguinal herniorrhaphy (LBIH) regarding pain, recurrence, and cosmetic results.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Bilateral inguinal hernias are common in children.
- Current surgical options include laparoscopic bilateral inguinal herniorrhaphy (LBIH).
- A novel single-incision bilateral inguinal herniorrhaphy (SBIH) approach has been developed.
Purpose of the Study:
- To evaluate the safety and feasibility of SBIH in pediatric patients.
- To compare SBIH with LBIH in terms of operative time, postoperative pain, recurrence, and complications.
- To assess patient satisfaction with cosmetic outcomes for both procedures.
Main Methods:
- STROBE-compliant retrospective cohort study.
- Inclusion of 101 pediatric patients (6 months to 12 years) with bilateral inguinal hernias.
- Comparison between 56 patients undergoing SBIH and 45 patients undergoing LBIH.
Main Results:
- No significant differences in operative time, postoperative pain, recurrence, or complications between SBIH and LBIH groups.
- SBIH showed significantly shorter operative time in girls compared to boys and girls in the LBIH group.
- Lower postoperative pain was observed in boys undergoing SBIH compared to LBIH.
- Both procedures yielded equally high patient satisfaction with cosmetic results.
Conclusions:
- SBIH is a safe and feasible surgical approach for pediatric bilateral inguinal hernias.
- SBIH demonstrates comparable efficacy to LBIH with low recurrence and complication rates.
- SBIH offers satisfactory cosmetic outcomes and potential advantages in operative time and pain reduction for specific patient groups.
Abstract:
To introduce the use of a new surgical approach named single-incision bilateral inguinal herniorrhaphy (SBIH) in pediatric surgical population.This was a STROBE-compliant retrospective cohort study using data from 101 patients who had undergone bilateral inguinal herniorrhaphy in our institution. Children with bilateral inguinal hernias without contraindications for surgery, ranging in age from 6 months to 12 years, were included. Fifty-six children with bilateral inguinal hernias underwent SBIH (SBIH group) and 45 patients underwent laparoscopic bilateral inguinal herniorrhaphy (LBIH) (LBIH group). Differences in operative time, postoperative pain, recurrence, and complications between the 2 groups were analyzed. Patient satisfaction with cosmetic result was also investigated using questionnaires.There were no statistically significant differences in operative time (P = .2257), postoperative pain (P = .0607), recurrence (P = .8756), and complications (P = .7467) between the 2 groups. Interestingly, the operation time of girls in SBIH group was significantly shorter than that of the boys in this group (P < .0001), but also shorter than that of girls in LBIH group (P = .0038). Postoperative pain for boys was lower in SBIH group than in the LBIH group (P = .0340). No ascending testis, testicular atrophy, and hydrocele occurred in either group. According to the questionnaire, both procedures had equally high levels of satisfaction for cosmetic results (P = .7531).Initial results show that SBIH for pediatric patients, regardless of gender, is a safe and feasible procedure compared with LBIH with an equally low recurrence rate, few complication, and satisfactory cosmetic outcomes.
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