Our Summary

This research paper is an updated guide on the best practices for laparoscopic treatment of abdominal wall hernias, a condition where an organ pushes through an opening in the muscle or tissue that holds it in place. The original guide was published in 2014 by the International Endohernia Society (IEHS). However, as medical advancements are made, these guidelines need to be updated to reflect the latest findings and techniques.

The update includes research published from 2012 to 2017. It was discussed and confirmed during two conferences in Beijing and Cologne. The update includes new surgical techniques, such as the application of Botox and robot-assisted methods.

The researchers highlight that there has been a significant increase in the number of patients with this condition, and many surgeons are now interested in new techniques for treating it, such as minimally invasive procedures using robotics and laparoscopy.

Despite the new techniques not having been thoroughly evaluated yet, the researchers felt it was important to include them in the guide to encourage further research.

In order to fully understand the guidelines, both the original guide and the update should be read together. The researchers recommend updating the guide every three years to keep up with the latest science.

FAQs

  1. What is the purpose of the updated guide on laparoscopic treatment of abdominal wall hernias?
  2. What new surgical techniques are included in the updated guide for pediatric hernia repair?
  3. How often do the researchers recommend updating the guide on laparoscopic treatment of abdominal wall hernias?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric hernia repair is to follow the post-operative care instructions carefully. This may include avoiding strenuous activities, keeping the incision site clean and dry, and taking any prescribed medications as directed. It’s important to follow up with the doctor for any scheduled appointments to ensure proper healing.

Suitable For

Pediatric patients who are typically recommended for hernia repair include those with inguinal hernias, umbilical hernias, and other abdominal wall hernias. Inguinal hernias are the most common type of hernia in children, and they often require surgical repair to prevent complications such as incarceration and strangulation. Umbilical hernias are also common in infants and young children, and surgery may be recommended if the hernia does not resolve on its own by age 4 or 5. Other types of abdominal wall hernias, such as epigastric hernias or incisional hernias, may also require surgical repair depending on the size and symptoms of the hernia.

Overall, pediatric patients who are experiencing symptoms such as pain, swelling, or a visible bulge at the site of the hernia are typically recommended for hernia repair. It is important for parents and caregivers to consult with a pediatric surgeon to determine the most appropriate treatment plan for their child.

Timeline

Before pediatric hernia repair:

  1. Patient experiences symptoms such as a bulge in the abdomen, pain or discomfort, and sometimes vomiting.
  2. Patient undergoes physical examination and possibly imaging tests to confirm the diagnosis of a hernia.
  3. Surgical consultation is scheduled to discuss treatment options, risks, and benefits of hernia repair.

After pediatric hernia repair:

  1. Patient undergoes laparoscopic hernia repair surgery, which involves making small incisions in the abdomen to repair the hernia with mesh.
  2. Patient is monitored in the recovery room before being discharged home the same day or the following day.
  3. Patient may experience some pain, swelling, and bruising at the surgical site, which can be managed with pain medication and rest.
  4. Follow-up appointments are scheduled to monitor healing and ensure there are no complications.
  5. Patient gradually resumes normal activities and is advised to avoid heavy lifting or strenuous exercise for a few weeks post-surgery.

What to Ask Your Doctor

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

  1. What type of hernia does my child have and what are the treatment options available?
  2. Is surgery the best option for my child’s hernia, or are there non-surgical alternatives?
  3. What are the risks and potential complications associated with pediatric hernia repair surgery?
  4. What is the expected recovery time for my child after hernia repair surgery?
  5. Will my child need to follow any specific post-operative care instructions or restrictions?
  6. Are there any long-term effects or considerations to be aware of following pediatric hernia repair surgery?
  7. What is the success rate of pediatric hernia repair surgery, and what is the likelihood of recurrence?
  8. Are there any specific dietary or lifestyle changes my child should make before or after hernia repair surgery?
  9. What is the experience and expertise of the surgical team performing my child’s hernia repair surgery?
  10. Are there any additional resources or support services available to help my child and our family through the hernia repair process?

Reference

Authors: Bittner R, Bain K, Bansal VK, Berrevoet F, Bingener-Casey J, Chen D, Chen J, Chowbey P, Dietz UA, de Beaux A, Ferzli G, Fortelny R, Hoffmann H, Iskander M, Ji Z, Jorgensen LN, Khullar R, Kirchhoff P, Köckerling F, Kukleta J, LeBlanc K, Li J, Lomanto D, Mayer F, Meytes V, Misra M, Morales-Conde S, Niebuhr H, Radvinsky D, Ramshaw B, Ranev D, Reinpold W, Sharma A, Schrittwieser R, Stechemesser B, Sutedja B, Tang J, Warren J, Weyhe D, Wiegering A, Woeste G, Yao Q. Journal: Surg Endosc. 2019 Oct;33(10):3069-3139. doi: 10.1007/s00464-019-06907-7. Epub 2019 Jun 27. PMID: 31250243