Laparoscopic vs. Open Hernia Repair

Fizan Abdullah dtl

General pediatric surgeon, Fizan Abdullah

Inguinal hernia, one of the most common conditions in children, occurs when part of the intestine bulges through a weak area in the abdominal muscle wall. In the traditional repair, surgeons make an incision over the groin, divide the skin and underlying muscle to access and tie off the hernial sac. Some surgeons choose the less-invasive laparoscopic approach in which three small incisions are made instead of the single large cut. Both the open and laparoscopic approaches require general anesthesia, and both are same-day outpatient procedures. Some retrospective studies show a greater recurrence rate with the minimally invasive approach, while others point to less pain medication needed and scarring using that method. So which approach should pediatric surgeons choose?

Johns Hopkins general pediatric surgeon Fizan Abdullah is trying to get at the answer through a randomized controlled trial of 151 inguinal hernia patients under age 3, half of whom will undergo the open surgery and half the laparoscopic procedure: “We are interested if children have to stay in the hospital longer, need more pain medication, or are more likely to have other complications depending on the type of operation they have. There have been retrospective studies but no prospective trial like this, which is very novel and exciting.”

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