Our Summary

This study looks at how pediatric surgeons and urologists have adopted a new laparoscopic method for repairing inguinal hernias in children. The researchers gathered data from child patients who had this surgery between 2017 and 2019, and also interviewed the surgeons who performed the operations.

They found that there were very few cases where the hernia reoccurred on the same side after using the new technique, and even fewer cases of the hernia occurring on the opposite side after the surgery.

The interviews with the surgeons revealed that ongoing learning, the culture within the surgical department, available resources, and specific technical aspects of the surgery were all factors that influenced whether or not a surgeon decided to use the new technique.

The study concludes that patient outcomes may have improved over time as surgeons learned more about the new technique. It also found that the rate at which the new method was adopted varied between different surgeons and departments. The study suggests further research into the “collegial model” - where surgeons learn from each other, similar to an apprenticeship - to better understand how to encourage the uptake of new, evidence-based surgical techniques.

FAQs

  1. What is the new laparoscopic method for repairing inguinal hernias in children, and how does it differ from traditional methods?
  2. What factors influenced a surgeon’s decision to use the new technique for pediatric hernia repair, according to the study?
  3. What is the “collegial model” and how could it potentially enhance the adoption of new surgical techniques?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric hernia repair is to discuss with the surgeon the possibility of using a laparoscopic method for the surgery. This new technique has shown promising results in reducing the risk of hernia recurrence and complications. It is important to have a thorough discussion with the surgeon about the benefits and risks of this approach to determine the best course of action for your child’s hernia repair.

Suitable For

Patients who are typically recommended pediatric hernia repair are infants, children, and adolescents who have been diagnosed with inguinal hernias. Inguinal hernias are common in pediatric patients, with the condition often presenting as a bulge in the groin area. Pediatric hernia repair is typically recommended for patients who are experiencing symptoms such as pain, discomfort, or complications related to the hernia.

The laparoscopic method for repairing inguinal hernias in children, as discussed in the study, may be recommended for pediatric patients who are suitable candidates for this minimally invasive surgical approach. Candidates for laparoscopic hernia repair may include patients with unilateral or bilateral inguinal hernias, as well as patients with recurrent or complex hernias.

Ultimately, the decision to recommend pediatric hernia repair, as well as the choice of surgical technique, will depend on factors such as the patient’s age, overall health, the severity of the hernia, and the preferences of the surgical team. It is important for pediatric patients and their caregivers to consult with a pediatric surgeon or urologist to determine the most appropriate treatment plan for their specific case.

Timeline

Before pediatric hernia repair:

  • Child is diagnosed with an inguinal hernia, which may present as a bulge or swelling in the groin area.
  • Consultation with a pediatric surgeon or urologist to discuss treatment options.
  • Pre-operative evaluation to assess the child’s overall health and readiness for surgery.
  • Consent obtained from the parents or guardians for the procedure.
  • Surgery scheduled and pre-operative instructions given to the child and their family.

After pediatric hernia repair:

  • Child undergoes laparoscopic hernia repair surgery, which involves making small incisions in the abdomen to repair the hernia using a camera and specialized instruments.
  • Post-operative care in the recovery room to monitor the child’s vital signs and ensure a smooth recovery.
  • Child is discharged home with instructions on wound care, pain management, and activity restrictions.
  • Follow-up appointments scheduled to monitor the child’s healing progress and address any concerns.
  • Long-term outcomes assessed to determine the success of the surgery and any potential complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric hernia repair surgery?
  2. How long will the recovery process be for my child after the surgery?
  3. Will my child need to stay overnight in the hospital after the surgery?
  4. What kind of post-operative care will my child need at home?
  5. Are there any restrictions on physical activity or diet that my child should follow after the surgery?
  6. How likely is it that the hernia will reoccur after the surgery?
  7. What are the advantages of using laparoscopic surgery for pediatric hernia repair compared to traditional open surgery?
  8. How experienced are you in performing pediatric hernia repair surgeries with the new laparoscopic technique?
  9. What is the success rate of the new laparoscopic technique for pediatric hernia repair in your practice?
  10. Are there any specific steps or precautions that can be taken to reduce the risk of hernia recurrence after the surgery?

Reference

Authors: Altschuler A, Chong AJ, Alavi M, Herrinton LJ. Journal: J Laparoendosc Adv Surg Tech A. 2021 Aug;31(8):947-953. doi: 10.1089/lap.2021.0179. Epub 2021 May 27. PMID: 34042514