Our Summary

This study looks at a less invasive procedure for repairing inguinal hernias in children, called single-port, laparoscopic, needle-assisted repair (LNAR). The procedure also allows for the assessment and repair of a related condition if necessary. The study was conducted in a developing country where such laparoscopic procedures are not commonly used.

The researchers performed 148 hernia repair operations on 117 children, ranging in age from one month to 15 years, over the course of two years. The average time for the surgery was about 21 minutes, and most patients were able to leave the hospital within six hours.

There were no complications during the surgeries themselves, but six patients (5.1%) experienced complications after the surgery. These complications included residual hydrocele, wound site seroma, and recurrent inguinal hernia. All these complications occurred during the first year of the study.

The researchers noticed that both the duration of the surgeries and the length of hospital stays decreased significantly in the second year of the study, indicating a learning curve with the new procedure.

The cost for the complete treatment was less than $80 per patient, a cost comparable to the traditional open herniotomy at the same institution.

In summary, the study suggests that single-port LNAR can be a safe, cost-effective method for hernia repair in children, even in developing countries where laparoscopic procedures are not commonly used. However, the procedure does come with a learning curve.

FAQs

  1. What is the single-port, laparoscopic, needle-assisted repair (LNAR) procedure for pediatric hernia repair?
  2. What were the observed complications in the study after the hernia repair surgeries?
  3. Did the duration of surgeries and the length of hospital stays improve over the course of the study?

Doctor’s Tip

A doctor might advise a patient that pediatric hernia repair using single-port, laparoscopic, needle-assisted repair (LNAR) is a safe and cost-effective option. The procedure has been shown to have shorter surgery times and hospital stays compared to traditional open herniotomy. It is important to note that there may be a learning curve for the surgeon when performing this procedure, but overall it can be a beneficial option for pediatric hernia repair.

Suitable For

Pediatric patients who are typically recommended for pediatric hernia repair include children with inguinal hernias, umbilical hernias, or other types of hernias that are causing symptoms or complications. In this study, the researchers specifically looked at children ranging in age from one month to 15 years who required inguinal hernia repair.

Timeline

  • Before pediatric hernia repair: A child may experience symptoms such as a visible bulge in the groin area, pain or discomfort, and vomiting. The child and their family will visit a healthcare provider for an evaluation and diagnosis of an inguinal hernia.

  • Day of pediatric hernia repair: The child will undergo a single-port, laparoscopic, needle-assisted repair (LNAR) procedure that takes approximately 21 minutes. The surgery is minimally invasive and allows for assessment and repair of related conditions if necessary.

  • After pediatric hernia repair: Most patients are able to leave the hospital within six hours of the surgery. Some patients may experience complications such as residual hydrocele, wound site seroma, or recurrent inguinal hernia, which can occur in the first year after the surgery. However, the duration of surgeries and hospital stays decrease significantly in the second year of the study, indicating a learning curve with the new procedure. The cost of treatment is also found to be less than $80 per patient, making it a cost-effective method for hernia repair in children.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric hernia repair using single-port LNAR?

  2. How experienced is the surgeon in performing single-port LNAR for pediatric hernia repair?

  3. What is the expected recovery time and post-operative care for a child undergoing this procedure?

  4. Are there any long-term effects or considerations to be aware of after the hernia repair using single-port LNAR?

  5. How does the cost of single-port LNAR compare to traditional open herniotomy for pediatric hernia repair?

  6. Are there any specific guidelines or restrictions for the child’s activities or diet following the hernia repair using single-port LNAR?

  7. Will the child need any follow-up appointments or monitoring after the hernia repair using single-port LNAR?

  8. How likely is it for the hernia to recur after undergoing this procedure?

  9. Are there any alternative treatment options for pediatric hernia repair that should be considered?

  10. What is the success rate of single-port LNAR for pediatric hernia repair in comparison to other surgical methods?

Reference

Authors: Rajbhandari N, Karki B, Guglielmetti LC, Vuille-Dit-Bille RN. Journal: J Laparoendosc Adv Surg Tech A. 2021 Jan;31(1):124-129. doi: 10.1089/lap.2020.0547. Epub 2020 Sep 28. PMID: 32990497