Our Summary

This research paper examines the effectiveness of two different surgical procedures used to repair inguinal hernias in children: open repair (which is the standard approach) and laparoscopic repair (which is a newer method, involving smaller incisions and a camera to guide the surgery).

The researchers wanted to see if there was a difference in how often the hernia returned after surgery between the two methods (this was the main outcome they were interested in). They also looked at other factors like how much pain the child had after surgery, how long the surgery took, and whether there were any infections at the site of the surgery.

They reviewed five studies that had been previously conducted on this topic, and found that there was no significant difference between the two methods in terms of how often the hernia came back, or any of the other outcomes they were interested in.

Therefore, they concluded that there’s no strong evidence to suggest that the laparoscopic method is any better than the standard open repair method for treating inguinal hernias in children.

FAQs

  1. What are the two different surgical procedures used to repair inguinal hernias in children?
  2. Was there any significant difference found between the open repair and laparoscopic repair methods in terms of hernia recurrence and other outcomes?
  3. What conclusion did the researchers reach about the effectiveness of the laparoscopic method compared to the standard open repair method for treating inguinal hernias in children?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic hernia repair is to follow post-operative instructions carefully, including avoiding heavy lifting and strenuous activities for a certain period of time to ensure proper healing and minimize the risk of hernia recurrence. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can also help prevent future hernias.

Suitable For

Patients who are typically recommended for laparoscopic hernia repair include those who have inguinal hernias, umbilical hernias, or incisional hernias. Inguinal hernias are the most common type of hernia and occur when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. Umbilical hernias occur near the belly button and are common in infants, while incisional hernias occur at the site of a previous surgical incision.

Laparoscopic hernia repair may be recommended for patients who are looking for a minimally invasive approach to surgery, as it involves smaller incisions and typically results in less pain and a faster recovery time compared to open repair. Additionally, patients who have had previous hernia repairs that have failed or who have a higher risk of complications with open surgery may also be good candidates for laparoscopic hernia repair.

Overall, the decision to recommend laparoscopic hernia repair will depend on the individual patient’s specific condition and medical history, and should be made in consultation with a healthcare provider.

Timeline

Before laparoscopic hernia repair:

  • Patient experiences symptoms of a hernia, such as a bulge in the abdomen or groin area, pain or discomfort, and potentially nausea or vomiting.
  • Patient sees a doctor for evaluation and diagnosis of the hernia.
  • Patient and doctor discuss treatment options, including the possibility of laparoscopic hernia repair.
  • Patient undergoes pre-operative testing and preparation for surgery.

During laparoscopic hernia repair:

  • Patient is placed under general anesthesia.
  • Surgeon makes small incisions in the abdomen and inserts a camera and surgical instruments to repair the hernia.
  • Hernia is repaired using mesh to reinforce the weakened area of the abdominal wall.
  • Surgery typically takes around 1-2 hours.

After laparoscopic hernia repair:

  • Patient wakes up in the recovery room and is monitored for any complications.
  • Patient may experience some pain or discomfort at the incision sites, which can be managed with pain medication.
  • Patient is usually able to go home the same day as the surgery.
  • Patient is instructed on how to care for the incision sites and when to follow up with the surgeon.
  • Patient may need to avoid heavy lifting or strenuous activities for a few weeks after surgery.
  • Patient follows up with the surgeon for post-operative evaluation and to ensure proper healing of the hernia repair.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with laparoscopic hernia repair compared to open repair?
  2. How long is the recovery time expected to be after laparoscopic hernia repair?
  3. Will I have any restrictions on physical activity or lifting after the surgery?
  4. How experienced are you in performing laparoscopic hernia repairs?
  5. Are there any specific factors that make me a better candidate for laparoscopic hernia repair versus open repair?
  6. How will you determine which type of surgery is best for me?
  7. What is the success rate of laparoscopic hernia repair in terms of preventing hernia recurrence?
  8. Will I need to have any follow-up appointments or tests after the surgery?
  9. How should I prepare for the surgery, both physically and mentally?
  10. Are there any alternative treatments or procedures that I should consider before deciding on laparoscopic hernia repair?

Reference

Authors: Mahmood B, Christoffersen M, Miserez M, Bisgaard T. Journal: Dan Med J. 2020 Jul 1;67(7):A12190725. PMID: 32734885