Laparoscopic Herniorrhaphy in the Pediatric Age Group: What About the Learning Curve?

Bertozzi, Mirko; Melissa, Berardino; Magrini, Elisa; Bini, Vittorio; Appignani, Antonino

doi:10.1089/end.2012.0690

Cited by 19 publications

(8 citation statements)

References 16 publications

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“…Three studies were available. Bertozzi et al 19 compared open with laparoscopic approach for inguinal hernia repair and analyzed the learning experience for the laparoscopic group. Hernia recurrences occurred only in the first 10 cases, a stable mean operative time was reached after 20 procedures for unilateral and 15 cases for bilateral herniorrhaphies, concluding that the learning curve requires a minimum of 20 procedures (►Tables 1 and 2).…”

Section: Inguinal Hernia Repairmentioning

confidence: 99%

Minimally Invasive Pediatric Surgery: The Learning Curve

et al. 2020

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The use of minimally invasive surgery (MIS) in pediatric patients has increased over the past decades. The process of mastering a new procedure is termed the learning curve, during which the ability to operate increases but poorer outcomes are produced. We aim to analyze the current evidence on learning curves in pediatric MIS and evaluate its impact on patient's clinical outcomes. A systematic literature search was performed for studies listed on PubMed that reported on the learning curve for MIS surgical procedures. Studies were included if they stated the number of procedures required to reach a consistency in outcomes or if they compared outcomes between early and late period of MIS experience regarding the endpoints operative time, conversions, and intra-/postoperative complications. A total of 22 articles reporting on 11 surgical procedures were included in the study. Most authors reported a significant decrease in operative time as well as peri- and postoperative complications with increasing experience of the surgeon. Complications ranged from minor to major, the latter being especially severe for patients receiving pyloromyotomy (5–7% higher risk of mucosal perforation), esophageal atresia repair (15% higher leakage rate and 19–77% higher stenosis rate), or Kasai portoenterostomy (26–35% more liver transplants in the first year after surgery) during the learning curve period. Pediatric MIS comes with a considerable learning curve that may have a significant impact on the patient's clinical outcomes. Efforts should be made to minimize the effect of the learning curve on the patients.

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Section: Inguinal Hernia Repairmentioning

confidence: 99%

Minimally Invasive Pediatric Surgery: The Learning Curve

et al. 2020

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“…al. (17) stated that number of cases required to perform laparoscopic inguinal hernia repair safely without supervision was 20 cases. However, the treatment of transumbilical single-port laparoscopic IH (PIRS) has been found to be much easier to learn and apply due to no need for classical three-port laparoscopy maneuvers (18).…”

Section: Discussionmentioning

confidence: 99%

The investigation survey of inguinal hernia operation techniques preferred by pediatric surgeons in Turkey

Bahadır¹,

Serttürk²,

Ergün³

et al. 2021

J Exp Clin Med

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In inguinal hernia, standard procedure has been considered open repair for a long time, the number of pediatric surgeons who prefer laparoscopic techniques is increasing day by day. In this study, it was aimed to determine how pediatric surgeons in our country approach patients with inguinal hernia and manage the treatment process. Controversial issues on inguinal hernia repair were identified and a questionnaire was prepared to reveal the current situation. The questionnaire was delivered to members of Turkish Association of Pediatric Surgery on the official website of the association. The survey was directed to 420 people, 92 people returned with the answers to the questionnaire. Thirty-six of the surgeons prefer the laparoscopic method for inguinal hernia repair. The reason for choosing open surgery was questioned, the most frequent answer was to be more experienced and to have more cumulative knowledge on open repair method. According to survey, the greatest advantage of laparoscopy was stated to be the better evaluation of the contralateral inguinal canal (n=16, %44.4). Twelve of surgeons who performed laparoscopic treatment in the selection of patients stated that gender is important and prefer laparoscopic surgery for female patients. Thirty percent (n = 11) of the participants stated that they prefer laparoscopy in patients between 3 months and 13 years old, while the rest prefer laparoscopy at all ages. In conclusion thirty nine percent of surgeons in Turkey prefer laparoscopic repair. Open repair is still preferred in our country. There is still no consensus on perfect method and patient selection yet.

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“…Bilateral hernia and occult hernia in children are were very common, and the incidence of occult hernia was 21% according to Zhou [20]. Steinau reported that 5% to 10% of children with unilateral hernia have a contralateral oblique hernia after surgery [21], and Shalaby and Bertozzi both reported that about 10% to 20% of patients diagnosed with unilateral inguinal hernia before surgery were found to have a contralateral occult hernia during the laparoscopic operation [22,23]. In the present study, 46 patients in the laparoscopic group who were diagnosed with a unilateral inguinal hernia before surgery were found during the exploration to have a contralateral inner ring that was not closed, and 10 patients in the conventional group were found to have an occult hernia on the contralateral side during the follow-up period, which required a second operation.…”

Section: Discussionmentioning

confidence: 99%

Single-Site Laparoscopic Percutaneous Extraperitoneal Closure of the Internal Ring Using an Epidural Needle for Children with Inguinal Hernia

Zhang¹,

Zhang²,

Chen³

et al. 2019

Med Sci Monit

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Backgroud This study evaluated the safety and effectiveness of single-site laparoscopic percutaneous extraperitoneal closure of the internal ring using an epidural needle for children with inguinal hernia. Material/Methods We retrospectively analyzed clinical data of 542 children with inguinal hernia who underwent single-site laparoscopic percutaneous extraperitoneal closure of the internal ring using an epidural needle at our hospital from June 2014 to June 2017. Results All patients successfully underwent surgery and none were converted to conventional surgery. Abdominal vascular injury, vasectomy injury, testicular vascular injury, umbilical hernia, iatrogenic cryptorchidism, testicular atrophy, hydrocele, hernia recurrence, and scrotal edema were not reported during the perioperative period. A follow-up of these patients was performed for 12–24 months. During the follow-up period, umbilical hernia, iatrogenic cryptorchidism, testicular atrophy, and hydrocele were not noted, but 3 cases of hernia recurrence were found. Conclusions The single-site laparoscopic percutaneous extraperitoneal closure of the internal ring using an epidural needle for children with inguinal hernia is safe and effective, and this procedure has the advantages of minimal trauma, no scarring, and good cosmetic effect.

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Laparoscopic Herniorrhaphy in the Pediatric Age Group: What About the Learning Curve?

Cited by 19 publications

References 16 publications

Minimally Invasive Pediatric Surgery: The Learning Curve

Minimally Invasive Pediatric Surgery: The Learning Curve

The investigation survey of inguinal hernia operation techniques preferred by pediatric surgeons in Turkey

Single-Site Laparoscopic Percutaneous Extraperitoneal Closure of the Internal Ring Using an Epidural Needle for Children with Inguinal Hernia

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