Our Summary

This research paper looks at two different surgical methods for treating inguinal hernias in infants, namely laparoscopic repair (LR) and open hernia repair (OR). The study analyzed data of 465 infants who underwent these surgeries between 2006 and 2015.

The results showed that in the group that underwent OR, around 16.1% had to have surgery on both sides of the groin area and 13.6% developed another hernia on the opposite side during the follow-up period. However, in the group that underwent LR, 75.8% had surgery on both sides and only 1.6% developed another hernia later on.

The average time taken to perform the surgery was about the same for both methods if the hernia was on one side only. However, if the hernia was on both sides, the LR method was faster.

There was no significant difference between the two methods in terms of the number of post-surgery complications such as the hernia recurring or wound infection. However, swelling in the scrotum after surgery was more common in the OR group.

The study concludes that the LR method is better for infants with inguinal hernia as it has a lower risk of another hernia developing later, takes less time, and has fewer post-surgery complications.

FAQs

  1. What is the difference between Laparoscopic Repair (LR) and Open Hernia Repair (OR) in treating infants with inguinal hernia?
  2. Is there a significant difference in operation times between Laparoscopic and Open Hernia Repair in infants?
  3. What are the comparative postoperative complications between Laparoscopic and Open Hernia Repair in infants?

Doctor’s Tip

A helpful tip a doctor might give a patient about laparoscopic hernia repair is to expect shorter operation times compared to open hernia repair, as well as a lower incidence of metachronous hernia and potentially better postoperative outcomes. It may also be mentioned that postoperative scrotal swelling is more common in open hernia repair.

Suitable For

Infants with inguinal hernia are typically recommended for laparoscopic hernia repair, especially if they have bilateral hernias or are at risk for developing metachronous contralateral hernias. This study found that laparoscopic repair in infants resulted in a lower incidence of metachronous hernia, shorter operation times, and better postoperative outcomes compared to open hernia repair. Therefore, laparoscopic repair could be considered the primary operation method in infants with inguinal hernia.

Timeline

  • Before laparoscopic hernia repair:
  1. Patient presents with symptoms of inguinal hernia such as a bulge in the groin area.
  2. Patient undergoes physical examination and possibly imaging studies to confirm the diagnosis.
  3. Patient discusses treatment options with their healthcare provider, including the possibility of laparoscopic hernia repair.
  4. Patient undergoes preoperative preparations such as fasting and medication adjustments.
  • After laparoscopic hernia repair:
  1. Patient undergoes laparoscopic hernia repair procedure, which involves making small incisions and inserting a camera and instruments to repair the hernia.
  2. Patient is monitored in the recovery room postoperatively for any complications.
  3. Patient is discharged home the same day or after a short hospital stay, depending on the individual case.
  4. Patient may experience mild discomfort, swelling, or bruising in the surgical area, which typically resolves within a few days.
  5. Patient follows postoperative instructions provided by their healthcare provider, including restrictions on lifting and physical activity.
  6. Patient attends follow-up appointments to ensure proper healing and assess for any complications.

What to Ask Your Doctor

  1. What are the benefits of laparoscopic hernia repair compared to open hernia repair for infants?
  2. What is the success rate of laparoscopic hernia repair in infants?
  3. How long is the recovery period after laparoscopic hernia repair for infants?
  4. Are there any potential risks or complications associated with laparoscopic hernia repair in infants?
  5. How experienced are you in performing laparoscopic hernia repair in infants?
  6. Are there any specific criteria that make a patient a good candidate for laparoscopic hernia repair?
  7. How often do infants who undergo laparoscopic hernia repair require additional surgeries for metachronous hernias?
  8. What is the typical follow-up care after laparoscopic hernia repair in infants?
  9. How does the cost of laparoscopic hernia repair compare to open hernia repair for infants?
  10. Are there any specific precautions or restrictions that need to be followed after laparoscopic hernia repair in infants?

Reference

Authors: Ho IG, Ihn K, Koo EJ, Chang EY, Oh JT. Journal: J Pediatr Surg. 2018 Oct;53(10):2008-2012. doi: 10.1016/j.jpedsurg.2018.01.022. Epub 2018 Feb 7. PMID: 29477445