Laparoscopic Hernia Repair versus Open Herniotomy in Children: A Controlled Randomized Study

Abstract

Background. Laparoscopic hernia repair in infancy and childhood is still debatable. The objective of this study is to compare laparoscopic assisted hernia repair versus open herniotomy as regards operative time, hospital stay, postoperative hydrocele formation, recurrence rate, iatrogenic ascent of the testis, testicular atrophy, and cosmetic results. Patients and Methods. Two hundred and fifty patients with inguinal hernia were randomized into two equal groups. Group A was subjected to laparoscopic inguinal hernia repair. Group B was subjected to open herniotomy. The demographic data were matched between both groups. Assessment of the testicular volume and duplex assessment in preoperative, early, and late postoperative periods were done. Results. All cases were completed successfully without conversion. The mean operative time for group A was 7.6 ± 3.5 minutes, 9.2 ± 4.6 minutes and 11.4 ± 2.7 minutes, for unilateral hernia, unilateral hernia in obese child, and bilateral hernia, respectively. The recurrence rate was 0.8% in group A, whereas in group B the recurrence rate was 2.4%. Conclusion. Laparoscopic hernia repair by RN is an effective line of hernia repair. It resulted in marked reduction of operative time, low rate of recurrence, no testicular atrophy, no iatrogenic ascent of the testis, and excellent cosmetic results.

Laparoscopic Extracorporeal Ligation of the Internal Inguinal Ring by a Spinal Needle: a Simple Method of Hernia Repair in Children

“…While in laparoscopic hernia repair, it ranged from 0.7 to 4.5 % [16]. On the contrary, Shalaby et al had reported a lower recurrence rate (0.8 %) after laparoscopic repair by RN and 2.4 % recurrence after open herniotomy [15].…”

“…And an important step of transecting the sac in open herniotomy is not achieved in many laparoscopic techniques. The skip areas in the IIR and leaving the sac in continuity without disconnection may be the cause of subsequent recurrence of hernia and hydrocele formation in the postoperative period [9,16,17].…”

Laparoscopic Herniotomy – A Single Centre Study of 150 Cases

“…Safety and efficacy of laparoscopic hernia repair especially in female patients and in patients with initial left sided hernia [24]. In comparison with open herniotomy, shorter operative time for unilateral as well as bilateral hernias, less post-operative complications was also observed without an difference in recurrence rate [25,26,27].…”

Der Stellenwert der minimalinvasiven Chirurgie bei der Behandlung der Leistenhernie und Pylorusstenose

“…Letztere Technik wurde umfangreich publiziert und analysiert [11,12]. Die Literaturrecherche zur laparoskopischen Leistenhernienkorrektur bei Kindern liefert in PubMed ad hoc 217 Titel, davon 4 randomisierte kontrollierte Studien [13][14][15][16] und 2 Metaanalysen [17,18].…”