Our Summary

Inguinal hernia repair is a common surgery in children and in Australia, the traditional open repair (OR) method is often chosen over the newer laparoscopic repair (LR) method. This study, conducted between January 2017 and July 2021, compared the outcomes of these two methods in infants. The research team reviewed records of 376 patients aged less than 1 year who had undergone either of these surgeries.

The results showed that LR was performed in 73 patients and OR in 303. The LR method was more commonly used for bilateral repairs (repairs on both sides). All patients who underwent LR were given general anesthesia, compared to 82.8% of patients who underwent OR.

There were no instances of the hernia recurring in the LR group, while there were 3 recurrences in the OR group. Additionally, 10% of patients who underwent OR developed a contralateral inguinal hernia (a hernia that occurs on the opposite side) after their operation.

In terms of other complications like wound infection, blood clot formation, testicular shrinkage, and fluid accumulation, the study found no significant difference between the two groups.

In conclusion, while OR was more commonly performed, the study found that the rates of complications were similar between the two methods. However, those who underwent OR were more likely to develop a contralateral hernia.

FAQs

  1. What is the difference between the traditional open repair method and the laparoscopic repair method for inguinal hernia repair?
  2. Are there any notable differences in complications or recurrences between the open repair and laparoscopic repair methods?
  3. What percentage of patients developed a contralateral inguinal hernia after undergoing the open repair method?

Doctor’s Tip

A helpful tip from a doctor to a patient undergoing laparoscopic hernia repair would be to follow post-operative care instructions closely to ensure a smooth recovery. This may include avoiding heavy lifting, following a gentle exercise routine as recommended by the surgeon, and maintaining a healthy diet to promote healing. It is also important to attend follow-up appointments to monitor progress and address any concerns promptly. By following these guidelines, patients can help reduce the risk of complications and achieve optimal outcomes after surgery.

Suitable For

Based on the findings of this study, laparoscopic hernia repair may be recommended for infants with bilateral inguinal hernias to reduce the risk of recurrence and contralateral hernia development. Additionally, laparoscopic repair may be a suitable option for infants who are able to tolerate general anesthesia. Overall, laparoscopic hernia repair seems to be a safe and effective option for infants with inguinal hernias.

Timeline

Overall, the timeline for a patient undergoing laparoscopic hernia repair would typically involve:

  1. Pre-operative consultation: The patient meets with their surgeon to discuss the procedure, risks, benefits, and any necessary preparations.

  2. Surgery day: The patient arrives at the hospital or surgical center, undergoes the laparoscopic hernia repair procedure under general anesthesia, and is monitored post-operatively.

  3. Recovery: The patient may experience some discomfort, bruising, and swelling in the days following the surgery. They are typically able to resume normal activities within a few days to a week.

  4. Follow-up appointments: The patient will have follow-up appointments with their surgeon to ensure proper healing and address any concerns.

After laparoscopic hernia repair, patients typically experience shorter recovery times, less post-operative pain, and lower rates of complications compared to traditional open repair methods. This study reinforces the benefits of laparoscopic hernia repair in infants, particularly in reducing the risk of hernia recurrence and contralateral hernia development.

What to Ask Your Doctor

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

  1. What are the benefits of laparoscopic hernia repair compared to traditional open repair?
  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 repair?
  4. Will I need general anesthesia for laparoscopic hernia repair?
  5. How experienced are you in performing laparoscopic hernia repair?
  6. Are there any specific factors that would make me a better candidate for laparoscopic hernia repair over open repair?
  7. What is the success rate of laparoscopic hernia repair in terms of hernia recurrence?
  8. Will I be able to resume normal activities sooner with laparoscopic hernia repair compared to open repair?
  9. Are there any long-term differences in outcomes between laparoscopic and open hernia repair?
  10. What are the costs associated with laparoscopic hernia repair compared to open repair?

Reference

Authors: Leng S, Jackson T, Houlton A, Dumitriu E, Pacilli M, Nataraja R. Journal: ANZ J Surg. 2022 Oct;92(10):2505-2510. doi: 10.1111/ans.17962. Epub 2022 Aug 5. PMID: 36221201