Laparoscopic and open approach for inguinal hernia in pediatric age: report of 8 years.

BACKGROUND

Ongoing innovation in laparoscopy lead pediatric surgeons to consider a mini-invasive approach for inguinal hernia correction. We review cases and evolution of surgical technique in a pediatric center.

METHODS

A retrospective study included patients that underwent inguinal hernia repair between 01/01/2011 and 30/06/2019. Surgical techniques are compared. Outcomes considered: surgery duration, intraoperative and postoperative complications.

RESULTS

Six Hundred sixty-four patients were included; 187 patients underwent laparoscopy(group A), 477 underwent open surgery(group B). Throughout time from 2011 to 2019, there has been an increase in laparoscopy, accounting in 2019 for more than 60% of overall surgeries. In 151 patients of group A initial diagnosis was of monolateral hernia; in 25.8% contralateral side was corrected at the same time because of intraoperative finding of open internal inguinal ring. Surgery duration in group B is shorter than group A; difference loses significance in bilateral corrections. Complications: 2.9% short term: prematurity related as well as to duration in group B. 1.7% relapses, regardless of technique. 5.2% metachronous hernias, related with age and open surgery. 0.6% secondary cryptorchidism, unrelated to technique.

CONCLUSIONS

There is not an evident superiority of laparoscopy over open repair. Laparoscopy should be preferred in case of doubt about bilaterality and in case of emergency surgery.