Pediatric Laparoscopic Inguinal Hernia Repair: A Review of the Current Evidence

Ponsky, Todd A.; Nalugo, Margaret; Ostlie, Daniel J.

doi:10.1089/lap.2014.9998

Cited by 33 publications

(12 citation statements)

References 35 publications

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“…CK Yeung in Hong Kong has been utilizing this approach for a number of years and has had excellent results (personal communication). Shalaby and Ponsky have also described their experience with this approach (8,12). These techniques are quite similar with the technique described in this article.…”

Section: Discussionmentioning

confidence: 62%

“…There have been several meta-analyses trying to compare the laparoscopic and open approaches for an indirect inguinal hernia (12,13,23,24). In one metaanalysis, 53 studies that described outcomes of the open hernia repair (OH) and the LH repair were reviewed (13).…”

Section: Discussionmentioning

confidence: 99%

“…In fact, the majority of studies published in the last 20 years have focused on the laparoscopic approach. There have been a number of case series describing an author's or institution's experience with the laparoscopic approach as well as several meta-analyses comparing the laparoscopic to the open technique (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). At our institution, we have transitioned the majority of inguinal hernia repairs to the laparoscopic approach.…”

mentioning

confidence: 99%

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The laparoscopic approach for repair of indirect inguinal hernias in infants and children

2017

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Repair of an indirect inguinal hernia is one of the most common operations performed around the world by pediatric surgeons. Until the last 15 years, most inguinal hernia repairs were performed using an inguinal crease incision and extraperitoneal ligation of the patent processes vaginalis. However, since 2000, the laparoscopic approach has gained popularity and there have been increasing descriptions about various techniques for laparoscopic hernia (LH) repair. At our institution, we have transitioned the majority of inguinal hernia repairs to the laparoscopic approach. In this article, we will describe the technique that is utilized at Children's Mercy Hospital in Kansas City, Missouri (USA) and express our thoughts on the current debate regarding laparoscopic versus open inguinal hernia repair in infants and children.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The laparoscopic approach for repair of indirect inguinal hernias in infants and children

2017

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“…One of the main criticisms of the laparoscopic techniques for repair of pediatric inguinal hernias is the recurrence rate. It ranged from 0.7 to 4.5% in most series [23][24][25][26]. It could possibly be due to closure of the internal ring under tension, broken purse-string suture, large size hernia and the missed area of the peritoneum over the vas deference and the testicular vessels making skip area susceptible for recurrence [27].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic repair of congenital inguinal hernia: a comparative study between purse–string suture and peritoneal disconnection with ligation techniques in bilateral cases

et al. 2020

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Background/purpose Many laparoscopic surgical techniques were described for management of inguinal hernia in pediatric patients. This prospective study was conducted to compare laparoscopic purse-string suture of hernia sac at the internal ring at one side, leaving the distal sac intact (technique I) and disconnection of the hernia sac with intra-corporeal suture of proximal part at the internal ring (technique II) in the other side in the same case. Patients and methods Thirty three patients with bilateral congenital inguinal hernia (66 repairs) were included in this study. The outcome variables were operative time, intraoperative complications, post-operative complications and recurrence rate. Results This study included 28 males and 5 females. The age of the patients ranged from 1 to 72 month with a mean of (15.27 ± 19.09). The operative time was shorter in technique I than in technique II and this difference was statistically significant. No intraoperative complications were reported. Five cases (15%) developed hydrocele and two cases (6%) developed recurrence in technique I during the follow up period. Conclusion Laparoscopic repair of congenital inguinal hernia using laparoscopic disconnection of the sac and closure of the internal ring has lower recurrence rate and hydrocele formation but longer operative time compared to laparoscopic purse-string closure alone. Due to the high rate of recurrence in technique I, there is definite superiority of technique II as a surgical option.

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“…However, one of the main concerns of pediatric surgeons is the fear of an increased recurrence rate although multiple studies in the literature have shown that recurrences after laparoscopy is lower than in the open approach [ 7 ]. Additionally, the higher cost due to the use of specialized monitors and instruments and the learning curve needed to master the laparoscopic approach were additional factors that held some surgeons back from adopting it, compared to the open technique which is simpler, easier to perform does not require specialized tools [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Is the open approach superior to the laparoscopic hernia repair in children? A retrospective comparative study

Al-Taher

Khrais

Alma’aitah

et al. 2021

Annals of Medicine and Surgery

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Background For many years now, inguinal hernia repair in children has been done either by the open approach or laparoscopically with laparoscopy having the edge in terms of cosmesis and postoperative pain. However, recent studies have called for a return of the open approach as it had a comparable result to laparoscopy with lesser cost. This study aims to compare the outcomes of the two approaches at our institution. Methods This is a retrospective analysis of the prospectively collected data of all patients aged between 6 months and 13 years who underwent open or laparoscopic inguinal hernia repair in the period between January 2017 and July 2019 at our institution. Results 155 patients were included in the study. 100 (64.5%) underwent open inguinal repair while 55 (35.5%) were done laparoscopically. There was no significant difference in the postoperative complications between the open and laparoscopic groups ( P = 0.66). The overall mean operative time for the laparoscopic group and the open group is (45.7 ± 15.2, 45.5 ± 15.4 min, P = 0.83) respectively. However, a subgroup analysis showed a statistical difference in the operative time in bilateral hernias favoring the laparoscopic approach, (44 ± 13.2, 63.2 ± 26.4 min respectively, P = 0.049). Laparoscopy was also associated with shorter times to full recovery compared to the open group (4.7 days, 7.5 days, P = 0.013). Surprisingly, there was no difference in the cosmetic outcome between the two groups which is contrary to the published literature. Conclusions Laparoscopic inguinal hernia repair in children is a feasible and reproducible procedure. It permits the evaluation of the contralateral groin without further incisions. In our study, laparoscopy was superior in terms of operative time in bilateral hernias and the time to recovery. Finally, an added benefit to laparoscopy is that it offers more training opportunities for fellows and residents to improve their laparoscopic skills.

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Pediatric Laparoscopic Inguinal Hernia Repair: A Review of the Current Evidence

Cited by 33 publications

References 35 publications

The laparoscopic approach for repair of indirect inguinal hernias in infants and children

The laparoscopic approach for repair of indirect inguinal hernias in infants and children

Laparoscopic repair of congenital inguinal hernia: a comparative study between purse–string suture and peritoneal disconnection with ligation techniques in bilateral cases

Is the open approach superior to the laparoscopic hernia repair in children? A retrospective comparative study

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