Related Experiment Video
Updated: Aug 26, 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 infants: an initial experience
Samantha Leng1, Tracy Jackson2, Adelene Houlton1
1Department of Paediatric Surgery & Surgical Simulation, Monash Children's Hospital, Melbourne, Victoria, Australia.
Insights
Open repair (OR) is common for pediatric inguinal hernias in Australia, but laparoscopic repair (LR) is gaining traction. While complication rates are similar, OR is linked to a higher risk of metachronous contralateral inguinal hernias in infants.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Inguinal hernia repair is a frequent pediatric surgical procedure.
- Open repair (OR) remains the primary method in Australian infants, contrasting with the growing international adoption of laparoscopic repair (LR).
- This study evaluates the initial outcomes of LR in a pediatric setting.
Purpose of the Study:
- To compare the initial outcomes of laparoscopic repair (LR) versus open repair (OR) for inguinal hernias in infants.
- To assess complication rates, recurrence, and the development of metachronous contralateral inguinal hernias (MCIH) between the two surgical approaches.
Main Methods:
- Retrospective review of infants (<1 year) undergoing LR or OR between January 2017 and July 2021.
- Data collected from electronic and scanned medical records.
- Statistical analysis included unpaired t-test, Mann-Whitney test, Fisher's exact test, and simple linear regression (P<0.05 significant).
Main Results:
- 376 patients analyzed: 73 LR, 303 OR.
- No recurrences observed with LR versus 3 with OR (P=1.0).
- Open repair (OR) had a 10% rate of metachronous contralateral inguinal hernias (MCIH), significantly higher than LR. No significant differences in other complications.
Conclusions:
- Operative complication rates were comparable between open repair (OR) and laparoscopic repair (LR) groups.
- Infants undergoing OR demonstrated a significantly higher likelihood of developing metachronous contralateral inguinal hernias (MCIH).
- Laparoscopic repair (LR) shows promise in reducing MCIH rates in pediatric inguinal hernia repair.
Background:
Inguinal hernia repair is a common operation performed in children. In Australia, open repair (OR) continues to be the preferred method of treatment in infants, despite laparoscopic repair (LR) gaining popularity amongst some international centres. Our aim was to analyse initial outcomes with LR at our paediatric centre.
Methods:
We conducted a retrospective review of all patients <1 year of age who received LR or OR between January 2017 and July 2021 at our institution. Data were retrieved from both electronic and scanned medical records. Data were analysed using an unpaired t-test, Mann-Whitney test, Fisher's exact test or simple linear regression. A P-value <0.05 was considered significant.
Results:
A total of 376 patients were identified: LR was performed in 73 patients, and OR in 303 patients. Bilateral repair was more common amongst patients receiving LR: 56.2% versus 21.5%, P = 0.0001, treating either a symptomatic hernia or an intra-operative contralateral inguinal defect (70%). All LR patients received general anaesthetic, compared to 82.8% of patients in the OR group, P = 0.0001. There were no recurrences following LR and 3 with OR (P = 1.0). The metachronous contralateral inguinal hernia rate following OR was 10% (21/206). There was no significant difference in other complications, including wound infection, haematoma, testicular atrophy, and hydrocele formation.
Conclusion:
In our population OR was performed more often than LR. Operative complication rates were equivalent between OR and LR groups. However, infants that underwent OR were significantly more likely to develop a MCIH.
