Our Summary

This research paper is about the best ways to treat a type of hernia in children, called an inguinal hernia. A hernia happens when an organ, usually part of the intestine, pushes through a weak spot in the muscle wall. An inguinal hernia is one that occurs in the groin area.

The authors of the paper are from the European Pediatric Surgeons’ Association. They tried to answer six questions about how best to treat these hernias. These questions covered topics such as what type of surgery to use, when to do the surgery, and what kind of anesthesia to use.

To answer these questions, they looked at a lot of previous research – over 5,000 articles. They then narrowed these down to 72 of the most relevant ones. They also did a special type of research called a meta-analysis, where they combined the results of several different studies.

Their findings suggest that using a technique called laparoscopic repair can be helpful for children with hernias on both sides of their groin and that for premature babies, it might be better to wait until they have left the hospital before doing the surgery. They also found that using regional anesthesia, which numbs only a specific area of the body, can reduce problems with breathing and pain after the surgery.

However, the authors note that the evidence for these recommendations is not very strong, and there was not enough good quality evidence to make recommendations on some topics. They suggest that doctors should consider the individual circumstances of each child, and the resources available at their hospital, when deciding how best to treat these hernias.

FAQs

  1. What is the most common type of surgery in children?
  2. What are the potential benefits of laparoscopic repair in pediatric inguinal hernia cases?
  3. What recommendations have been made for the optimal management of pediatric inguinal hernia repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric hernia repair is to discuss the option of laparoscopic repair, especially for children with bilateral hernias. Laparoscopic repair has been shown to shorten operation time for bilateral hernias compared to open repair. It is important to have a tailored approach to hernia repair based on the individual child’s needs and the expertise of the medical team involved.

Suitable For

Pediatric patients who are typically recommended for pediatric hernia repair include those with bilateral hernias, preterm infants, and those with respiratory difficulties or other medical conditions that may benefit from specific anesthesia techniques or timing of surgery. It is important to consider the individual patient’s medical history, age, and other factors when determining the optimal management strategy for pediatric hernia repair.

Timeline

Before pediatric hernia repair:

  • The patient may experience symptoms such as a noticeable bulge in the groin area, pain or discomfort, and possibly nausea or vomiting.
  • The patient and their family will meet with a pediatric surgeon to discuss the surgical options and prepare for the procedure.

After pediatric hernia repair:

  • The patient will undergo either open or laparoscopic hernia repair, depending on the recommendation of the surgeon.
  • Following the surgery, the patient will be monitored in the recovery room before being transferred to a hospital room or discharged home.
  • The patient may experience some pain or discomfort at the surgical site, which can be managed with pain medication.
  • The patient will be advised to avoid strenuous activities for a period of time and to follow up with the surgeon for post-operative care.
  • Overall, the patient should experience relief from the symptoms of the hernia and should be able to resume normal activities gradually as they heal.

What to Ask Your Doctor

Some questions a patient may consider asking their doctor about pediatric hernia repair include:

  1. What are the potential risks and benefits of laparoscopic versus open hernia repair in children?
  2. Is there a difference in outcomes between extraperitoneal and transperitoneal hernia repair in pediatric patients?
  3. Should my child undergo contralateral exploration during hernia repair surgery?
  4. What is the optimal timing for hernia repair in preterm infants?
  5. What anesthesia technique is recommended for preterm infants undergoing hernia repair?
  6. Is urgent surgery necessary for girls with irreducible ovarian hernia, and what are the potential risks associated with delaying the operation?

These questions can help the patient and their family make informed decisions about the best course of treatment for their child’s hernia.

Reference

Authors: Morini F, Dreuning KMA, Janssen Lok MJH, Wester T, Derikx JPM, Friedmacher F, Miyake H, Zhu H, Pio L, Lacher M, Sgró S, Zani A, Eaton S, van Heurn LWE, Pierro A. Journal: Eur J Pediatr Surg. 2022 Jun;32(3):219-232. doi: 10.1055/s-0040-1721420. Epub 2021 Feb 10. PMID: 33567466