Our Summary

This research paper compares the cost-effectiveness of two types of surgery for inguinal hernia (a type of hernia in the groin area) in young children: open surgery and laparoscopic surgery (a less invasive procedure using a small camera and miniaturized surgical instruments).

The study looked at the costs of these surgeries, taking into account the rate of recurrence (the hernia returning) and metachronous rate (hernia occurring on the opposite side).

They found that for surgeries where the child stayed overnight, the laparoscopic method was more cost-effective, even though it was slightly more expensive, because it had lower rates of recurrence and metachronous hernia.

However, for surgeries where the child went home the same day, the traditional open surgery was more cost-effective, despite having higher rates of recurrence and metachronous hernia, because it was significantly cheaper.

In other words, if your child needs to stay in the hospital overnight after hernia surgery, the laparoscopic method might be the better option, but if they can go home the same day, the traditional open surgery might be more cost-effective.

FAQs

  1. What types of surgeries for inguinal hernia in young children were compared in this research?
  2. Which method was found to be more cost-effective for surgeries where the child stayed overnight?
  3. Is the traditional open surgery more cost-effective for surgeries where the child can go home the same day, despite higher rates of hernia recurrence and metachronous hernia?

Doctor’s Tip

A doctor might advise a patient undergoing laparoscopic hernia repair to follow all post-operative instructions carefully, including avoiding heavy lifting or strenuous activities for a certain period of time to prevent complications and promote proper healing. They may also recommend maintaining a healthy diet and staying hydrated to aid in the recovery process. It is important for patients to communicate any concerns or unusual symptoms to their healthcare provider promptly.

Suitable For

Patients who are typically recommended for laparoscopic hernia repair include:

  1. Young children with inguinal hernias: As mentioned in the research paper, laparoscopic surgery may be more cost-effective for young children with inguinal hernias, especially if they need to stay in the hospital overnight.

  2. Patients with recurrent hernias: Laparoscopic surgery may be recommended for patients with recurrent hernias, as it has been shown to have lower rates of recurrence compared to open surgery.

  3. Patients with bilateral hernias: For patients with bilateral hernias (hernias on both sides of the groin), laparoscopic surgery may be preferred as it allows for repair of both hernias in a single procedure.

  4. Patients with large or complicated hernias: Laparoscopic surgery may be recommended for patients with large or complicated hernias, as it allows for better visualization and precision during the repair.

  5. Patients seeking a less invasive approach: Laparoscopic surgery is a minimally invasive procedure that involves smaller incisions and less post-operative pain compared to open surgery, making it a preferred option for patients seeking a less invasive approach to hernia repair.

It is important for patients to discuss their individual case with their healthcare provider to determine the most appropriate treatment option for their hernia.

Timeline

Before laparoscopic hernia repair:

  1. Patient experiences symptoms of a hernia such as a bulge in the groin area, pain or discomfort, and possible nausea or vomiting.
  2. Patient visits a doctor who diagnoses the hernia and recommends surgery.
  3. Patient undergoes pre-operative tests and evaluations to ensure they are a suitable candidate for surgery.
  4. Patient schedules a date for the surgery and receives instructions on how to prepare for the procedure.

After laparoscopic hernia repair:

  1. Patient arrives at the hospital or surgical center on the day of the surgery.
  2. Patient is prepped for surgery and given anesthesia.
  3. Surgeon makes small incisions in the abdomen and inserts a laparoscope to view the hernia and surrounding tissue.
  4. Hernia is repaired using mesh or sutures, and the incisions are closed.
  5. Patient is monitored in the recovery room before being discharged home the same day or staying overnight in the hospital.
  6. Patient is given post-operative instructions on pain management, wound care, and activity restrictions.
  7. Patient follows up with the surgeon for post-operative appointments to ensure proper healing and recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic hernia repair include:

  1. What are the potential benefits of laparoscopic hernia repair compared to traditional open surgery?
  2. What are the potential risks and complications associated with laparoscopic hernia repair?
  3. How long is the recovery time for laparoscopic hernia repair compared to open surgery?
  4. Will I need to stay overnight in the hospital after laparoscopic hernia repair, or can I go home the same day?
  5. What is the success rate of laparoscopic hernia repair in terms of preventing recurrence and metachronous hernia?
  6. Are there any specific factors that make me a better candidate for laparoscopic hernia repair over open surgery?
  7. What is the cost difference between laparoscopic hernia repair and open surgery, and will my insurance cover the procedure?
  8. How experienced are you in performing laparoscopic hernia repair, and what is your success rate with this procedure?
  9. Are there any specific post-operative care instructions or restrictions I should follow after laparoscopic hernia repair?
  10. Are there any alternative treatment options to consider besides laparoscopic hernia repair?

Reference

Authors: Lam CS, Dhedli PK, Russell S, Stedman FE, Hall NJ. Journal: J Laparoendosc Adv Surg Tech A. 2022 Jul;32(7):805-810. doi: 10.1089/lap.2021.0800. Epub 2022 Apr 28. PMID: 35483082