Twenty-year experience with laparoscopic inguinal hernia repair in infants and children: considerations and results on 1833 hernia repairs

Esposito, Ciro; Escolino, Maria; Cortese, Giuseppe; Aprea, Gianfranco; Turrà, Francesco; Farina, Alessandra; Roberti, Agnese; Cerulo, Mariapina; Settimi, Alessandro

doi:10.1007/s00464-016-5139-8

Cited by 52 publications

(38 citation statements)

References 32 publications

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“…Esposito et al [38] stressed that it is crucial to section the peri-orificial peritoneum before closing it, and to use a nonabsorbable suture for the closure of the internal inguinal ring. Schier et al [5] decided to incise the peritoneum lateral to the internal inguinal ring after starting their series of laparoscopic hernia repair, because they noted recurrences.…”

Section: Discussionmentioning

confidence: 99%

Single-center, retrospective study of the outcome of laparoscopic inguinal herniorrhaphy in children

et al. 2017

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Laparoscopic hernia repairs are used increasingly in children.The purpose of this single-center cohort observational research study was to analyze the outcome of children treated surgically for unilateral or bilateral inguinal hernia using laparoscopy.We did a STROBE-compliant retrospective outcome analysis of pediatric, laparoscopic hernia repair. Consecutive laparoscopic herniorrhaphies in 123 children done between March 2, 2010, and March 1, 2014, were included in this analysis. Data analysis was based on reviewing the hospital records and a prospective questionnaire. We evaluated postoperative hernia recurrence rate, occurrence of postoperative complications, duration of postoperative pain medication, and wound cosmesis.We first performed laparoscopic inguinal herniorrhaphy according to the techniques described by Schier et al and Becmeur et al in March 2010. We treated 46 girls and 77 boys with laparoscopically confirmed inguinal hernias, and their ages ranged from 0 to 16 years. Of these, 77 children suffered from unilateral hernias, 30 from unilateral hernias with contralateral patency of the vaginal process, and 16 from indirect bilateral hernias. The median follow-up interval was 38 months (range: 13-58 months). Overall, 8 (6.5%) of these 123 patients experienced a recurrence of the inguinal hernia. Two patients (1.6%) suffered a postoperative infection. Postoperative pain medication was administered by parents for 1 to 3 days in 67 (63.8%) of the 105 families who answered the question, and no pain medication was administered by 5 (4.0%) parents. Wound cosmesis was rated by the parents as invisible or barely visible in 106 (86.2%) of 123 patients and esthetically disturbing in 4 (3.2%) children.Laparoscopic inguinal hernia repair carries a learning curve and is safe and efficient in children thereafter. Further prospective studies are required to evaluate the long-term outcome of laparoscopic inguinal hernia repair in children.

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Section: Discussionmentioning

confidence: 99%

Single-center, retrospective study of the outcome of laparoscopic inguinal herniorrhaphy in children

et al. 2017

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“…Small series (fewer than 80 patients) were excluded. Sixteen published studies met the inclusion criteria and were selected for analysis [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] (Fig. 1).…”

Section: Inguinal Hernia Repairmentioning

confidence: 99%

Derivation of a complication burden score based on disability-adjusted life years to assess patient burden following surgery: a pilot study

Mohtashami

Safa

Guadagno³

et al. 2020

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Background: Comparing adverse outcomes following alternative surgical interventions is a complex process for both patients and providers. Disability-adjusted life years (DALYs) are used globally as a quantitative indicator of burden of disease. However, DALYs have not been applied to the burden of postoperative complications. This study explores the feasibility and utility of DALYs in measuring the burden of postoperative complications, using 2 pediatric surgical procedures as a test model. Methods: A literature review was undertaken of postoperative complications following pediatric inguinal hernia repair and intestinal atresia repair. Relevant studies were included, and incidence rates and durations of all key complications were identified. Using existing disability weights of equivalent health states to the complications, we estimated the burden in DALYs of each complication. These estimates were combined into a unitary procedure-specific complication burden score. Results: The key complications contributing to the postoperative burden following inguinal hernia repair were recurrence (0.016 DALYs), hydrocele (0.010), metachronous hernia (0.014) and port-site hernia (0.012). In the case of intestinal atresia repair, death (6.278), reoperation (12.100), stenosis (5.025) and anastomotic stricture (5.327) accounted for most of the postoperative DALYs. The complication burden score was 0.06 DALYs for inguinal hernia and 36.86 for intestinal atresia repair. Conclusion: As a proof of concept, this study supports the feasibility of using DALYs to derive a complication burden score following surgical intervention, and to our knowledge it represents the first application of burden of disease metrics to postoperative adverse outcomes. Future studies should focus on deriving de novo disability weights for common postoperative complications and adverse outcomes.

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“…In 2017, a follow-up study was published by Esposito et al 15 on their experience with almost 1,300 laparoscopic inguinal hernia repairs. According to the report, no conversion to an open operation was necessary.…”

Section: Direct Inguinal Herniamentioning

confidence: 99%

Femoral, Direct, and Rare Inguinal Hernias in Children—An Update

Gödeke

Muensterer

2017

Eur J Pediatr Surg

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Pediatric surgeons deal with inguinal hernias on a regular basis. While most of these are straightforward in terms of diagnosis and therapy, occasionally what initially sounds like a routine case turns out to be a perplexing conundrum. This review discusses rare and unusual findings in the groin area that may mimic an indirect inguinal hernia, but are not. To provide good and effective care, pediatric surgeons should be readily familiar with the possible differential diagnosis of these entities, along with their specific management. In general, laparoscopy is one of the most useful interventions to discern unusual groin pathology from standard indirect inguinal hernias and in many cases provides an effective treatment option at the same time.

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Twenty-year experience with laparoscopic inguinal hernia repair in infants and children: considerations and results on 1833 hernia repairs

Cited by 52 publications

References 32 publications

Single-center, retrospective study of the outcome of laparoscopic inguinal herniorrhaphy in children

Single-center, retrospective study of the outcome of laparoscopic inguinal herniorrhaphy in children

Derivation of a complication burden score based on disability-adjusted life years to assess patient burden following surgery: a pilot study

Femoral, Direct, and Rare Inguinal Hernias in Children—An Update

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