Sutureless versus conventional open herniotomy in children with unilateral inguinal hernia.

BACKGROUND

Congenital inguinal hernia (CIH) is a common pediatric condition, with 400,000 to 600,000 children in India undergoing hernia repair annually. Traditional open herniotomy has been the standard treatment, but minimally invasive, sutureless techniques are gaining popularity. This study compares sutureless herniotomy with conventional herniotomy to assess feasibility, operative time, recurrence, and cosmetic outcomes. & MATERIAL & METHOD: This prospective, randomized controlled trial was conducted at Sheri Kashmir Institute of Medical Sciences from January 2019 to January 2024. A total of 120 pediatric patients undergoing CIH repair were randomly assigned to Group A (sutureless) and Group B (conventional suturing). In Group A, the hernia sac was divided without peritoneal suturing, while Group B involved suturing and layered closure. Outcomes measured included operative time, recurrence rates, complications, and cosmetic results. Statistical analyses were performed using chi-square and t-tests.

RESULTS

Sixty patients in each group were analyzed. Operative time was shorter in Group A (6.79 ± 3.45 min) compared to Group B (10.88 ± 6.57 min), though not statistically significant. Postoperative pain scores were lower in Group A, and no recurrences were observed in either group. Cosmetic outcomes were superior in Group A, with 58 patients rated as excellent, compared to 50 in Group B. Group A also had fewer cases of ischemic testicular atrophy (0% vs. 3.3%).

CONCLUSION

Sutureless herniotomy is a safe, effective alternative to conventional herniotomy in pediatric CIH repair, offering advantages like reduced operative time, less postoperative pain, and better cosmetic results. Further multi-center studies are recommended for validation.