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Laparoscopic and open approach for inguinal hernia in pediatric age: report of 8 years
Federica Bianchi1, Elettra Vestri2, Simone Patané2
1Division of Pediatric Surgery, Department of Surgery, Dentistry, Paediatrics and Gynecology, Woman & Child Hospital, University of Verona, Verona, Italy - federica.bianchi1987@gmail.com.
Insights
Laparoscopic and open surgery for pediatric inguinal hernias show similar outcomes. Laparoscopy is beneficial for suspected bilateral cases or emergency repairs, offering a minimally invasive option.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Pediatric surgeons are increasingly considering laparoscopic approaches for inguinal hernia repair.
- Innovations in laparoscopy have driven the exploration of mini-invasive techniques.
Purpose of the Study:
- To review cases and analyze the evolution of surgical techniques for pediatric inguinal hernia repair.
- Compare laparoscopic versus open surgical approaches in a pediatric center.
Main Methods:
- Retrospective study of pediatric patients undergoing inguinal hernia repair from 2011 to 2019.
- Comparison of surgical techniques, including surgery duration and complication rates.
- Analysis of intraoperative findings and postoperative outcomes.
Main Results:
- 664 patients included: 187 laparoscopy (Group A), 477 open surgery (Group B).
- Laparoscopy use increased to over 60% by 2019.
- Similar relapse rates (1.7%) for both techniques; metachronous hernias higher with open repair (5.2%).
Conclusions:
- No clear superiority of laparoscopy over open repair for pediatric inguinal hernias.
- Laparoscopy is recommended for suspected bilateral hernias and emergency surgeries.
- Both techniques demonstrate comparable safety profiles with low complication rates.
Background:
Ongoing innovation in laparoscopy lead pediatric surgeons to consider a mini-invasive approach for inguinal hernia correction. We review cases and evolution of surgical technique in a pediatric center.
Methods:
A retrospective study included patients that underwent inguinal hernia repair between 01/01/2011 and 30/06/2019. Surgical techniques are compared. Outcomes considered: surgery duration, intraoperative and postoperative complications.
Results:
Six Hundred sixty-four patients were included; 187 patients underwent laparoscopy(group A), 477 underwent open surgery(group B). Throughout time from 2011 to 2019, there has been an increase in laparoscopy, accounting in 2019 for more than 60% of overall surgeries. In 151 patients of group A initial diagnosis was of monolateral hernia; in 25.8% contralateral side was corrected at the same time because of intraoperative finding of open internal inguinal ring. Surgery duration in group B is shorter than group A; difference loses significance in bilateral corrections. Complications: 2.9% short term: prematurity related as well as to duration in group B. 1.7% relapses, regardless of technique. 5.2% metachronous hernias, related with age and open surgery. 0.6% secondary cryptorchidism, unrelated to technique.
Conclusions:
There is not an evident superiority of laparoscopy over open repair. Laparoscopy should be preferred in case of doubt about bilaterality and in case of emergency surgery.
