Our Summary
This research paper discusses a study comparing two types of surgery methods for children with groin (inguinal) hernias: laparoscopic hernia repair (LH) and open herniotomy (OH). The aim was to see which method was better in terms of surgery time, post-surgery complications, chances of the hernia coming back, and the rate of a hernia occurring on the opposite side later on.
The study looked at 1125 young patients who had hernia surgery in a single hospital in 2015. Of these, 202 had laparoscopic surgery (Group A) and 923 had open surgery (Group B). The researchers then looked at the patients’ medical records and spoke to their parents to gather information.
The findings showed that for girls with hernias on both sides, the laparoscopic surgery was quicker. The chances of fluid accumulation (hydrocele) after surgery were also lower in the laparoscopic group (1.5% vs 8.2%). The chances of the hernia returning were very similar for both groups. However, in patients with a hernia on one side, none in the laparoscopic group had a hernia occur on the other side later on, compared to 10.1% in the open surgery group. Also, most of these opposite-side hernias in the open surgery group occurred within three months of the first surgery. Girls and patients with an initial left-sided hernia were more likely to have a hernia on the other side after open surgery.
The study concluded that laparoscopic hernia repair in children is safe and effective, particularly for girls and patients with an initial left-sided hernia. The authors recommended that when laparoscopic surgery is performed, any potential for a hernia on the other side should be fixed at the same time.
FAQs
- What was the main aim of the study comparing laparoscopic hernia repair and open herniotomy in children?
- What were the results of the study in terms of surgery time, post-surgery complications, and the chance of hernia recurrence?
- What was the recommendation of the authors based on the findings of the study?
Doctor’s Tip
A helpful tip a doctor might tell a patient about laparoscopic hernia repair is to ask about the possibility of fixing any potential hernias on the other side during the same surgery. This can help reduce the chances of needing a second surgery later on. Additionally, patients should follow their doctor’s post-operative instructions carefully to ensure a smooth recovery and minimize the risk of complications.
Suitable For
In general, laparoscopic hernia repair is recommended for patients who are suitable candidates for minimally invasive surgery. This includes:
- Patients with groin (inguinal) hernias, particularly for children with hernias on both sides.
- Patients who are at a higher risk for complications with open surgery, such as those with certain medical conditions or previous surgeries.
- Patients who prefer a faster recovery time and less post-operative pain.
- Patients who may benefit from the reduced risk of a hernia occurring on the opposite side later on.
It is important for patients to discuss their specific situation with their healthcare provider to determine if laparoscopic hernia repair is the best option for them.
Timeline
Before laparoscopic hernia repair, a patient typically experiences symptoms of a hernia such as a bulge or discomfort in the groin area. They may undergo a physical examination to confirm the hernia and discuss treatment options with their healthcare provider. After deciding on laparoscopic hernia repair, the patient will undergo pre-operative tests and preparations.
During the laparoscopic hernia repair surgery, the patient is placed under general anesthesia and small incisions are made in the abdomen. A laparoscope (a thin tube with a camera) and surgical instruments are inserted through these incisions to repair the hernia. The procedure usually takes around 30-60 minutes.
After the surgery, the patient will be monitored in the recovery room before being discharged home the same day. They may experience some pain, swelling, or bruising at the incision sites, which can be managed with pain medication. The patient will be advised to avoid strenuous activities for a few weeks and to follow a specific diet to aid in recovery.
In the weeks following laparoscopic hernia repair, the patient will have follow-up appointments with their healthcare provider to ensure proper healing and to address any concerns. Overall, laparoscopic hernia repair is a minimally invasive and effective treatment option for hernias, with a lower risk of complications and quicker recovery compared to open surgery.
What to Ask Your Doctor
Some questions a patient should ask their doctor about laparoscopic hernia repair include:
- What are the potential benefits of laparoscopic hernia repair compared to open herniotomy?
- What are the potential risks or complications associated with laparoscopic hernia repair?
- How long does the surgery typically take and what is the recovery time compared to open surgery?
- Will I have a lower chance of developing a hernia on the opposite side if I choose laparoscopic surgery?
- How experienced are you in performing laparoscopic hernia repair procedures?
- Will I need any specific pre-operative tests or preparations for the laparoscopic surgery?
- What is the success rate of laparoscopic hernia repair in terms of preventing hernia recurrence?
- Will there be any scarring or long-term effects from the laparoscopic surgery?
- What kind of post-operative care or follow-up will be needed after laparoscopic hernia repair?
- Are there any specific lifestyle changes or precautions I should take after the surgery to prevent future hernias?
Reference
Authors: Zhu LL, Xu WJ, Liu JB, Huang X, Lv ZB. Journal: Hernia. 2017 Jun;21(3):417-423. doi: 10.1007/s10029-017-1607-x. Epub 2017 Apr 19. PMID: 28424930