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Laparoscopic paediatric inguinal hernia repair: lessons learned from 102 cases
Lukas O'Brien1, Enda Hannan2, Sinead Hassett3
1Department of Paediatric Surgery, Children's Health Ireland at Crumlin, Dublin, Ireland. lukas.o-brien@ucdconnect.ie.
Insights
Paediatric laparoscopic inguinal hernia repair (LIHR) is a safe and effective treatment for children. This study shows LIHR has a low recurrence and complication rate, making it a viable option.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Pediatric inguinal hernias (IHs) are common surgical conditions.
- Laparoscopic inguinal hernia repair (LIHR) was first described in 1993.
- Current treatment lacks a gold standard, with both open and laparoscopic approaches used.
Purpose of the Study:
- To retrospectively evaluate the initial experience with LIHR in pediatric patients.
- To assess the safety and efficacy of LIHR in a pediatric population.
Main Methods:
- Retrospective observational cohort study.
- Inclusion of all pediatric patients undergoing LIHR.
- Examination of intraoperative and postoperative outcomes.
Main Results:
- 102 pediatric patients underwent LIHR, with a median age of 5 months; 31.4% were neonates.
- No intraoperative vascular or visceral injuries occurred.
- A 1.9% recurrence rate was observed, primarily in early cases before technique modification. Overall complication rate was 7.1%.
Conclusions:
- Pediatric LIHR is safe, feasible, and effective.
- The procedure is associated with a short hospital stay, low recurrence, and low complication rates.
- LIHR is versatile for elective and emergency pediatric IH across a wide age range.
Introduction:
Paediatric inguinal hernias (IHs) are common. The first paediatric laparoscopic hernia repair was described by El-Gohary and colleagues in the United Arab Emirates in 1993. Both laparoscopic inguinal hernia repair (LIHR) and open repair still exist concurrently with no consensus on gold standard treatment at present. The purpose of this study was to retrospectively evaluate our initial experience with LIHR in paediatric patients.
Methods:
A retrospective observational cohort study of all paediatric patients that underwent LIHR in our institution was performed. Intraoperative and postoperative outcomes were examined.
Results:
During the study period, 102 patients were scheduled for LIHR. The majority (76.5%) were male with a median age of 5 months. Thirty two patients (31.4%) were neonates at the time of surgery. The majority of cases (83.3%) were elective procedures. There were no instances of intraoperative vascular or visceral injury. Most patients underwent surgery as a day case. Eighteen patients underwent bilateral LIHR. The recurrence rate was 1.9%. These occurred in the first two patients to undergo LIHR, after which no recurrences were observed following a modification of the technique. The overall complication rate was 7.1%, most of which were managed conservatively.
Conclusion:
Paediatric LIHR is a safe, feasible and effective procedure that is associated with a short inpatient length of stay, a low recurrence rate and low postoperative complication rate. The technique is versatile and can be used to treat both elective and emergency presentations with IH in a wide age range.
