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Published on: November 12, 2021
Laparoscopic extraperitoneal technique versus open inguinal herniotomy in children: historical controlled
Arada Suttiwongsing1, Jiraporn Khorana2,3, Patchara Ruangwongroj4,5
1Division of Pediatric Surgery, Department of Surgery, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
Insights
Laparoscopic hernia repair in children shows comparable outcomes to open repair, potentially reducing metachronous contralateral hernias. Both surgical methods offer similar benefits and drawbacks.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Indirect inguinal hernias are common in children.
- Traditional open inguinal hernia (OH) repair is a standard procedure.
- Laparoscopic hernia (LH) repair offers a minimally invasive alternative.
Purpose of the Study:
- To compare surgical outcomes of laparoscopic extraperitoneal simple purse string method (LH) versus traditional open inguinal hernia (OH) repair in pediatric patients.
- To evaluate operative time, recurrence, complications, and incidence of metachronous contralateral inguinal hernia (MCIH) and contralateral patent processus vaginalis (CPPV).
Main Methods:
- A historical-controlled intervention study comparing 95 LH cases (2018-2019) with 210 OH cases (2016-2017).
- Analysis of operative time, overall complications, CPPV, and MCIH incidence between the two groups.
Main Results:
- No significant difference in overall complications between LH and OH groups.
- Operative time was significantly less for unilateral OH in females compared to LH (15.7 vs 20.5 min).
- Incidence of CPPV was 15.7% in the LH group and MCIH was 10.9% in the OH group.
Conclusions:
- Laparoscopic hernia repair may decrease the incidence of metachronous contralateral hernias, potentially avoiding a second surgery.
- Both open and laparoscopic techniques demonstrate equivalent efficacy and safety profiles for pediatric inguinal hernia repair.
Objective:
To compare surgical outcomes of percutaneous extraperitoneal simple purse string method of laparoscopic hernia (LH) repair with a traditional open inguinal hernia (OH) repair in children with indirect inguinal hernia in a single center.
Methods:
This study is a historical-controlled intervention study of two groups of patients: patients in the controlled group had OH repair performed from January 2016 to December 2017, and patients in the study group had LH repair from January 2018 to December 2019 at a single institution. Outcomes of the OH and LH groups, in terms of operative time, recurrence, complications, incidence of metachronous contralateral inguinal hernia (MCIH) and contralateral patent processus vaginalis (CPPV) were analyzed.
Results:
Three hundred and five patients were enrolled in the study. Among them, 95 cases underwent laparoscopic percutaneous extraperitoneal closure herniotomy (LH group), and 210 cases underwent conventional open herniotomy (OH group). In terms of operative time, only unilateral herniotomy in females of the OH group was significantly less than that of the LH group (15.7±7.1 vs 20.5±7.4 min, p=0.004). No significant difference in overall complication was observed between the two groups of patients. The incidence of CPPV in the LH group was 15.7% (15/95), and MCIH in OH group was 10.9% (23/210).
Conclusions:
Laparoscopic herniotomy may prevent the need for a second operation of metachronous contralateral hernia. Both open and laparoscopic techniques are equivalent in pro and cons.
