Related Experiment Video
Updated: Oct 7, 2025
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Laparoscopic versus open inguinal hernia repair in children: A systematic review
Jie Zhao1, Chengjun Yu1, Jiandong Lu1
1Department of Urology, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; National Clinical Research Center for Child Health and Disorders, Chongqing, China.
Insights
Laparoscopic herniorrhaphy (LH) offers advantages over open herniorrhaphy (OH) for paediatric inguinal hernias (PIH), including shorter operative times for bilateral cases and fewer complications. Both techniques are comparable, but LH shows superiority in specific outcomes.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Outcomes Research
Background:
- Paediatric inguinal hernia (PIH) repair techniques are debated.
- Laparoscopic herniorrhaphy (LH) and open herniorrhaphy (OH) are common methods.
Purpose of the Study:
- To systematically compare the efficacy and safety of LH versus OH for PIH.
- To evaluate operative time, complication rates, and recurrence.
Main Methods:
- Systematic review of randomized controlled trials (RCTs).
- Searched multiple databases (PubMed, Web of Science, Cochrane, etc.) without language or region restrictions.
- Included 13 RCTs involving 1207 patients.
Main Results:
- LH demonstrated shorter operative time for bilateral PIH repair.
- LH showed a lower overall complication rate, including wound infection and major male-specific post-operative complications.
- LH also had a lower incidence of contralateral metachronous inguinal hernia (CMIH).
- No significant differences were noted for unilateral operative time, recovery time, hospital stay, recurrence, or hydrocele rates.
Conclusions:
- Both LH and OH are comparable for PIH repair.
- LH presents advantages in operative time for bilateral hernias, complication rates, and CMIH incidence.
- Further rigorously designed RCTs are needed to confirm these clinical effects.
Purpose:
Considerable debates exist regarding the preferable technique to repair a paediatric inguinal hernia (PIH). This systematic review aims to compare the efficacy and safety of laparoscopic herniorrhaphy (LH) and open herniorrhaphy (OH) in PIH.
Methods:
The randomised controlled trials (RCTs) that compared the outcomes of LH and OH in PIH without region and language restrictions searched from the following databases: PubMed, Web of Science Database, Cochrane Library, SciELO Citation Index, Russian Science Citation Index, China National Knowledge Infrastructure, WanFang Data and China Science and Technology Journal Database.
Results:
A total of 13 RCTs that involving 1207 patients included in the review. The LH displayed a shorter operative time for bilateral hernia repair (weighted mean difference = -8.23, 95% confidence interval [CI]: -11.22~-5.23, P < 0.00001), a lower complication rate (odds ratio [OR] = 0.32, 95% CI: 013-0.83, P = 0.02) along with a lower wound infection (OR = 0.14, 95% CI: 0.04-0.55, P = 0.005) and major male-specific post-operative complications (OR = 0.10, 95% CI: 0.04-0.24, P < 0.00001) and a less contralateral metachronous inguinal hernia (CMIH) incidence rate (OR = 0.09, 95% CI: 0.02-0.42, P = 0.002). No significant difference was found for unilateral operative time, time to full recovery, length of hospital stay, recurrence and hydrocele rates between the two techniques.
Conclusion:
The present review reiterates that both the LH and OH techniques for the PIH repair are comparable. However, in some aspects, the LH is superior to the OH in terms of operative time for bilateral hernias, post-operative complications rate and CMIH incidence rate. Rigorously designed RCTs are anticipated to confirm the clinical effects of both LH and OH.
