Our Summary

This study looked at how pediatric surgeons at U.S. children’s hospitals are handling inguinal hernia repairs - a common childhood surgery. They compared traditional methods to laparoscopic methods - a less invasive surgery where a small camera is used to guide the procedure.

The researchers analyzed data from over 125,000 inguinal hernia repairs done at 32 children’s hospitals over a ten-year period. They found that most of the surgeries (92.4%) were done using traditional methods, but the use of laparoscopic procedures increased five times during the study period, from 3% to 15%.

They also found that laparoscopic procedures were more common among certain groups: girls, African-American children, children covered by government insurance, younger kids, and those needing repairs on both sides. These surgeries were also more expensive.

The researchers concluded that the use of laparoscopic procedures is on the rise and that further research is needed to understand the long-term outcomes of these surgeries.

FAQs

  1. What types of methods were compared in this study on pediatric hernia repairs?
  2. What groups had a higher frequency of laparoscopic procedures for hernia repairs according to the study?
  3. Has the use of laparoscopic procedures for pediatric hernia repairs increased or decreased over the study period?

Doctor’s Tip

A doctor might tell a patient that while traditional methods of pediatric hernia repair are still commonly used, laparoscopic procedures are becoming more popular and may be a good option for certain patients. They may also advise the patient that laparoscopic procedures may be more expensive and that further research is needed to fully understand the long-term outcomes of these surgeries. It’s important for the patient to discuss all options with their healthcare provider and make an informed decision about the best treatment approach for their child.

Suitable For

Pediatric patients who are recommended for hernia repair typically include those with inguinal hernias that are causing symptoms such as pain, discomfort, or bulging in the groin area. In some cases, hernias may also lead to complications such as incarceration or strangulation, which may require urgent surgical intervention.

In the study mentioned, certain groups of pediatric patients were more likely to undergo laparoscopic hernia repair, including girls, African-American children, those covered by government insurance, younger kids, and those needing repairs on both sides. However, the decision to recommend a specific type of hernia repair method should be based on individual patient factors, such as the size and location of the hernia, the child’s overall health status, and the surgeon’s experience and preference.

Ultimately, the recommendation for pediatric hernia repair is made on a case-by-case basis by the pediatric surgeon after a thorough evaluation of the patient’s condition.

Timeline

Before pediatric hernia repair:

  1. Patient experiences symptoms such as a bulge in the groin or scrotum, pain or discomfort, and sometimes vomiting.
  2. Consultation with a pediatric surgeon to discuss treatment options and risks.
  3. Pre-operative tests such as blood work, imaging studies, and possibly a physical exam.
  4. Pre-operative instructions such as fasting before surgery and stopping certain medications.
  5. Consent form signed by parents or guardians.

After pediatric hernia repair:

  1. Patient undergoes surgery, either traditional open surgery or laparoscopic surgery.
  2. Recovery in the hospital for a few hours to monitor for any complications.
  3. Post-operative care at home, including pain management and wound care.
  4. Follow-up appointments with the surgeon to monitor healing and address any concerns.
  5. Gradual return to normal activities, with restrictions on physical activity for a period of time.
  6. Long-term follow-up to monitor for any recurrence of the hernia or other complications.

What to Ask Your Doctor

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

  1. What are the different surgical options for repairing my child’s hernia, and which method do you recommend?
  2. What are the potential risks and benefits of each surgical method?
  3. How experienced are you in performing pediatric hernia repairs, especially using laparoscopic techniques?
  4. What is the expected recovery time for my child after the surgery?
  5. Are there any specific post-operative care instructions or restrictions my child needs to follow?
  6. What are the potential long-term outcomes or complications associated with the chosen surgical method?
  7. How will pain management be handled during and after the surgery?
  8. Will my child need any follow-up appointments or tests after the surgery?
  9. What is the success rate of the chosen surgical method in treating pediatric hernias?
  10. Are there any lifestyle changes or precautions my child should take to prevent a recurrence of the hernia in the future?

Reference

Authors: Shaughnessy MP, Maassel NL, Yung N, Solomon DG, Cowles RA. Journal: J Pediatr Surg. 2021 Nov;56(11):2016-2021. doi: 10.1016/j.jpedsurg.2021.01.032. Epub 2021 Jan 27. PMID: 33549307