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Pediatric Surgery International

, Volume 34, Issue 12, pp 1293–1298 | Cite as

Comparison of laparoscopic and open pediatric inguinal hernia repairs at two institutions

  • Kelly F. Darmawan
  • Tiffany Sinclair
  • James C. Y. Dunn
Original Article

Abstract

Background/Purpose

The proposed benefits of laparoscopic inguinal hernia repair in the pediatric population include easier access to the contralateral groin and avoidance of manipulation of the spermatic cord; however, some studies also report higher recurrence rates. Due to these differences, the traditional open technique is still used by many pediatric surgeons. The objective of this study is to compare the outcomes of two institutions that employed different techniques.

Methods

We retrospectively reviewed pediatric patients who had open repair of inguinal hernias at hospital A or laparoscopic repair at hospital B. Data collection included age of patients, laterality, operative time, and complications.

Results

From 2010 to 2015, 154 patients underwent open repair at hospital A and 220 patients underwent laparoscopic repair at hospital B. The mean operative time was 52 min for the open technique and 23 min for the laparoscopic technique (p < 0.01). There were 2.6% complications and 0.65% recurrences with the open technique, compared to 4.6% complications and 2.7% recurrences with the laparoscopic technique (p > 0.2).

Conclusion

Laparoscopic hernia repairs at hospital B are associated with shorter operative times and have similar outcomes as open repairs at hospital A. A prospective study with both techniques done at the same institution is warranted.

Keywords

Laparoscopy Surgery Pediatric Inguinal hernia Outcomes 

Notes

Author contributions

KD: study conception and design, data acquisition, analysis and data interpretation, drafting of the manuscript, and critical revision. TS: critical revision. JCYD: study conception and design, drafting of the manuscript, and critical revision.

Funding

Not applicable.

Compliance with ethical standards

Conflict of interest

This study was not funded. All listed authors (Kelly F. Darmawan, Tiffany Sinclair, James C.Y. Dunn) declare that he/she has no conflict of interest and has not received research grants for this study.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of retrospective study, formal consent is not required.

References

  1. 1.
    Alzahem A (2011) Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis. Pediatr Surg Int 27(6):605–612CrossRefGoogle Scholar
  2. 2.
    Gause CD, Casamassima MGS, Yang J, Hsiung G, Rhee D, Salazar JH et al (2017) Laparoscopic versus open inguinal hernia repair in children ≤ 3: a randomized controlled trial. Pediatr Surg Int 33(3):367–376CrossRefGoogle Scholar
  3. 3.
    Linnaus ME, Ostlie DJ (2016) Complications in common general pediatric surgery procedures. Semin Pediatr Surg 25(6):404–411CrossRefGoogle Scholar
  4. 4.
    Yang C, Zhang H, Pu J, Mei H, Zheng L, Tong Q (2011) Laparoscopic vs open herniorrhaphy in the management of pediatric inguinal hernia: a systemic review and meta-analysis. J Pediatr Surg 46(9):1824–1834CrossRefGoogle Scholar
  5. 5.
    Antonoff MB, Kreykes NS, Saltzman DA, Acton RD (2005) American academy of pediatrics section on surgery hernia survey revisited. J Pediatr Surg 40(6):1009–1014CrossRefGoogle Scholar
  6. 6.
    Davies DA, Rideout DA, Clarke SA (2017) The International Pediatric Endosurgery Group evidence-based guideline on minimal access approaches to the operative management of inguinal hernia in children. J Laparoendosc Adv Surg Tech A.  https://doi.org/10.1089/lap.2016.0453 CrossRefPubMedGoogle Scholar
  7. 7.
    Shalaby R, Ismail M, Samaha A, Yehya A, Ibrahem R, Gouda S et al (2014) Laparoscopic inguinal hernia repair; experience with 874 children. J Pediatr Surg 49(3):460–464CrossRefGoogle Scholar
  8. 8.
    Bruzoni M, Jaramillo JD, Kastenberg ZJ, Wall JK, Wright R, Dutta S (2015) Long-term follow-up of laparoscopic transcutaneous inguinal herniorrhaphy with high transfixation suture ligature of the hernia sac. J Pediatr Surg 50(10):1767–1771CrossRefGoogle Scholar
  9. 9.
    Kastenberg Z, Bruzoni M, Dutta S (2011) A modification of the laparoscopic transcutaneous inguinal hernia repair to achieve transfixation ligature of the hernia sac. J Pediatr Surg 46(8):1658–1664CrossRefGoogle Scholar
  10. 10.
    Raveenthiran V, Agarwal P (2017) Choice of repairing inguinal hernia in children: open versus laparoscopy. Indian J Pediatr 84(7):555–563CrossRefGoogle Scholar
  11. 11.
    Coté CJ, Notterman DA, Karl HW, Weinberg JA, McCloskey C (2000) Adverse sedation events in pediatrics: a critical incident analysis of contributing factors. Pediatrics 105(4):805–814CrossRefGoogle Scholar
  12. 12.
    Zhu LL, Xu WJ, Liu JB, Huang X, Lv ZB (2017) Comparison of laparoscopic hernia repair and open herniotomy in children: a retrospective cohort study. Hernia 21(3):417–423CrossRefGoogle Scholar
  13. 13.
    Ho IG, Ihn K, Koo EJ, Chang EY et al (2018) Laparoscopic repair of inguinal hernia in infants: comparison with open hernia repair. J Pediatr Surg 53:2008–2012CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Kelly F. Darmawan
    • 1
  • Tiffany Sinclair
    • 2
  • James C. Y. Dunn
    • 2
  1. 1.David Geffen School of Medicine at University of California, Los AngelesLos AngelesUSA
  2. 2.Division of Pediatric Surgery, Department of SurgeryStanford UniversityStanfordUSA

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