Laparoscopic versus open repair for paediatric inguinal hernia

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Evidence-Based Medicine

Background:

• Inguinal hernia is a common pediatric surgical condition.
• Laparoscopic and open surgical techniques are used for repair.
• A need exists for high-quality evidence comparing these approaches in children.

Purpose of the Study:

• To compare the benefits and harms of laparoscopic versus open inguinal hernia repair in children.
• To evaluate recurrence rates, complications, and pain associated with each surgical method.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Searched multiple databases (CENTRAL, MEDLINE, Embase) from 1993 onwards.
• Included 12 RCTs involving 1247 children; assessed risk of bias and certainty of evidence using GRADE.

Main Results:

• No significant difference in recurrence rates between laparoscopic and open repair (low-certainty evidence).
• Inadequate data to conclude on intraoperative injuries, severe complications (Clavien-Dindo 3a, 5), or acute postoperative pain.
• No difference observed for moderate complications (Clavien-Dindo 3b-4); chronic pain was not reported.

Conclusions:

• Laparoscopic and open repair show similar recurrence rates in children.
• Current evidence is of very low to low certainty, limiting definitive conclusions on safety and pain.
• High-quality trials with standardized reporting are needed for future comparisons.