Abstract
Inguinal hernia repair (IHR) is a common procedure in childhood. Laparoscopic IHR has been evolving for the last three decades. Although clear advantages have been shown, adaptation in Germany has been slow. We aim to study the current status of pediatric laparoscopic IHR. A survey was sent to all 89 pediatric surgical departments in Germany on current practices and preferences of open versus laparoscopic IHR. Two nationwide databases of administrative claims data from 2019 were analyzed and correlated with responses from the survey. A total of 56% of the pediatric surgical departments supplied data through the quality reports. The recall of our survey was 58% of all pediatric surgery departments. According to the pooled data, laparoscopic IHR was performed in 8.2% of all inpatients treated. Laparoscopic IHR was considered a training procedure in 48% of the departments. Five different laparoscopic techniques were described (most commonly percutaneous closure of the hernia under laparoscopic vision). The choice between open and laparoscopic IHR was mainly determined by the child’s age. Currently, only a minority of German children undergo inguinal hernia repair by laparoscopy. More training opportunities in the form of hands-on and video workshops may lead to more widespread employment of the laparoscopic technique.
Highlights
Inguinal hernia repair (IHR) is the most common surgical procedure in childhood
47.1% exclusively performed open IHR, 5.9% performed only laparoscopic IHR and both methods were performed in 47.1% of departments (Table 1)
Laparoscopic IHR was performed by fully trained specialists only in 51.6% of respondents, whereas it was considered a training procedure in 48.4% of the participating institutions
Summary
Inguinal hernia repair (IHR) is the most common surgical procedure in childhood. The incidence of inguinal hernia under the age of 18 years is estimated to be between 0.8 and4.4% [1]. Inguinal hernia repair (IHR) is the most common surgical procedure in childhood. The incidence of inguinal hernia under the age of 18 years is estimated to be between 0.8 and. It is much more common in males (male to female ratio is 5 to 1) [2]. The peak incidence is in the first year, whereas in girls it is at around 5 years of life [3]. Most of the inguinal hernias in children are indirect [2]. Pediatric inguinal hernia repair usually comprises dissection of the hernia sac at the inner inguinal ring followed by high ligation. Open IHR is an extra-abdominal procedure with a high success rate and few complications. It is still considered the most commonly performed approach in children
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