Our Summary

This study compared two types of surgery for groin hernia repair: laparoscopic percutaneous extraperitoneal closure (LPEC) and open herniorrhaphy (OH). The researchers looked at over 4,000 cases from a 20-year period. They found that LPEC took longer for single-side hernia repairs but was faster for double-side repairs. Anesthesia times were longer for both types of repair with LPEC. They also found that LPEC had a lower risk of a hernia developing on the opposite side later on, but a higher chance of the hernia coming back. There were three cases where a testicle had to be removed in the OH group, but none in the LPEC group. The results suggest that both methods have their pros and cons and the type of surgery should be chosen based on the patient’s specific needs.

FAQs

  1. What were the two types of pediatric hernia repair surgeries compared in this study?
  2. Which type of surgery took longer for single-side hernia repairs, and which was faster for double-side repairs?
  3. What were the findings of the study in terms of risk of hernia reoccurrence and risk of a hernia developing on the opposite side?

Doctor’s Tip

A doctor might tell a patient that pediatric hernia repair can be done using either laparoscopic percutaneous extraperitoneal closure (LPEC) or open herniorrhaphy (OH). Each method has its own advantages and disadvantages, so the choice of surgery should be based on the individual patient’s needs. It is important to discuss these options with the doctor to determine the best approach for the specific case.

Suitable For

Pediatric patients with groin hernias are typically recommended for pediatric hernia repair. Groin hernias are common in children and can cause discomfort, pain, and potential complications if left untreated. Pediatric hernia repair is usually recommended for children who have symptomatic hernias or hernias that are at risk of complications such as incarceration or strangulation. Children with asymptomatic hernias may also be recommended for surgery to prevent potential complications in the future. Overall, pediatric hernia repair is a safe and effective procedure for treating groin hernias in children.

Timeline

  1. Patient is diagnosed with a hernia and discusses treatment options with their healthcare provider.
  2. Patient undergoes pre-operative evaluation and any necessary tests to ensure they are healthy enough for surgery.
  3. Patient schedules a date for pediatric hernia repair surgery.
  4. On the day of surgery, patient arrives at the hospital or surgical center and is prepared for the procedure.
  5. Anesthesia is administered to the patient before the surgery begins.
  6. Pediatric hernia repair surgery is performed, either through laparoscopic percutaneous extraperitoneal closure (LPEC) or open herniorrhaphy (OH).
  7. After the surgery is completed, the patient is monitored in the recovery room before being discharged home.
  8. Patient may experience some pain, swelling, and discomfort in the days following surgery.
  9. Patient follows post-operative instructions provided by their healthcare provider, including restrictions on physical activity and proper wound care.
  10. Follow-up appointments are scheduled to monitor the healing process and ensure there are no complications.
  11. Over time, the patient should experience relief from the symptoms of their hernia and be able to resume normal activities.

What to Ask Your Doctor

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

  1. What are the risks and benefits of laparoscopic percutaneous extraperitoneal closure (LPEC) versus open herniorrhaphy (OH) for my child’s hernia repair?
  2. How will the choice of surgery method affect the length of the procedure and anesthesia time for my child?
  3. What is the likelihood of the hernia recurring after LPEC versus OH?
  4. Are there any specific factors about my child’s hernia that make them a better candidate for one type of surgery over the other?
  5. What is the likelihood of complications, such as testicular damage, with each type of surgery?
  6. How long is the recovery time expected to be for each type of surgery?
  7. Are there any long-term implications or considerations to take into account when choosing between LPEC and OH for my child’s hernia repair?
  8. How experienced are you in performing each type of surgery, and what is your success rate with each method?
  9. Are there any alternative treatment options for my child’s hernia that should be considered?
  10. What will the follow-up care and monitoring look like after my child undergoes hernia repair surgery?

Reference

Authors: Shibuya S, Imaizumi T, Yamada S, Yoshida S, Yamada S, Toba Y, Takahashi T, Miyazaki E. Journal: Surg Endosc. 2022 Feb;36(2):941-950. doi: 10.1007/s00464-021-08354-9. Epub 2021 Feb 22. PMID: 33616732