Kutay BAHADIR, Fırat SERTTURK, Ergun ERGÜN, Gülnur GÖLLÜ, Ege EVİN, Ahmet ÇAKMAK, Ufuk ATEŞ

The investigation survey of inguinal hernia operation techniques preferred by pediatric surgeons in Turkey

Abstract : Introduction :In inguinal hernia, standard procedure has been considered open repair for a long time, the number of pediatric surgeons who prefer laparoscopic techniques is increasing day by day. In this study, it was aimed to determine how pediatric surgeons in our country approach patients with inguinal hernia and manage the treatment process. Methods :Controversial issues on inguinal hernia repair were identified and a questionnaire was prepared to reveal the current situation. The questionnaire was delivered to members of Turkish Association of Pediatric Surgery on the official website of the association. Results :The survey was directed to 420 people, 92 people returned with the answers to the questionnaire. Thirty six of the surgeons prefer the laparoscopic method for inguinal hernia repair. The reason for choosing open surgery was questionned, the most frequent answer was to be more experienced and to have more cumulative knowledge on open repair method. According to survey, the greatest advantage of laparoscopy was stated to be the better evaluation of the contralateral inguinal canal (n=16, %44,4). Twelve of surgeons who performed laparoscopic treatment in the selection of patients stated that gender is important and prefer laparoscopic surgery for female patients. Thirty percent (n = 11) of the participants stated that they prefer laparoscopy in patients between 3 months and 13 years old, while the rest prefer laparoscopy at all ages. In conclusion thirty nine percent of surgeons in Turkey prefer laparoscopic repair. Open repair is stil preferred in our country. There is still no consensus on perfect method and patient selection yet.

Keywords:

Hernia, Inguinal, Laparoscopy, Surveys and Questionnaries,

PDF

___

1. Ron O, Eaton S, Pierro A. Systematic review of the risk of developing a metachronous contralateral inguinal hernia in children. Br J Surg. 2007;94(7):804-11.
2. Erdogan D, Karaman I, Aslan MK, Karaman A, Cavusoglu YH. Analysis of 3,776 pediatric inguinal hernia and hydrocele cases in a tertiary center. J Pediatr Surg. 2013;48(8):1767-72.
3. Nakashima M, Ide K, Kawakami K. Laparoscopic versus open repair for inguinal hernia in children: a retrospective cohort study. Surg Today. 2019;49(12):1044-50.
4. Olesen CS, Andresen K, Oberg S, Rosenberg J. Laparoscopic versus open repair of groin hernias in children: a systematic review and meta-analysis. Surg Endosc. 2019;33(7):2050-60.
5. Shalaby R, Ibrahem R, Shahin M, Yehya A, Abdalrazek M, Alsayaad I, et al. Laparoscopic Hernia Repair versus Open Herniotomy in Children: A Controlled Randomized Study. Minim Invasive Surg. 2012;2012:484135.
6. Patkowski D, Czernik J, Chrzan R, Jaworski W, Apoznanski W. Percutaneous internal ring suturing: a simple minimally invasive technique for inguinal hernia repair in children. J Laparoendosc Adv Surg Tech A. 2006;16(5):513-7.
7. Dreuning K, Maat S, Twisk J, van Heurn E, Derikx J. Laparoscopic versus open pediatric inguinal hernia repair: state-of-the-art comparison and future perspectives from a meta-analysis. Surg Endosc. 2019;33(10):3177-91.
8. Zani A, Eaton S, Hoellwarth M, Puri P, Tovar J, Fasching G, et al. Management of pediatric inguinal hernias in the era of laparoscopy: results of an international survey. Eur J Pediatr Surg. 2014;24(1):9-13.
9. Korkmaz M, Guvenc BH. Comparison of Single-Port Percutaneous Extraperitoneal Repair and Three-Port Mini-Laparoscopic Repair for Pediatric Inguinal Hernia. J Laparoendosc Adv Surg Tech A. 2018;28(3):337-42.
10. Chan YY, Durbin-Johnson B, Kurzrock EA. Pediatric inguinal and scrotal surgery - Practice patterns in U.S. academic centers. J Pediatr Surg. 2016;51(11):1786-90.
11. Fujiogi M, Michihata N, Matsui H, Fushimi K, Yasunaga H, Fujishiro J. Outcomes following laparoscopic versus open surgery for pediatric inguinal hernia repair: Analysis using a national inpatient database in Japan. J Pediatr Surg. 2019;54(3):577-81.
12. Yang C, Zhang H, Pu J, Mei H, Zheng L, Tong Q. Laparoscopic vs open herniorrhaphy in the management of pediatric inguinal hernia: a systemic review and meta-analysis. J Pediatr Surg. 2011;46(9):1824-34.
13. Esposito C, Escolino M, Turra F, Roberti A, Cerulo M, Farina A, et al. Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era. Semin Pediatr Surg. 2016;25(4):232-40.
14. Olesen CS, Andersen K, Oberg S, Deigaard SL, Rosenberg J. Variations in open and laparoscopic repair of paediatric inguinal hernia. Dan Med J. 2020;67(4).
15. Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13(4):343-403.
16. Yoshizawa J, Ashizuka S, Kuwashima N, Kurobe M, Tanaka K, Ohashi S, et al. Laparoscopic percutaneous extraperitoneal closure for inguinal hernia: learning curve for attending surgeons and residents. Pediatr Surg Int. 2013;29(12):1281-5.
17. Bertozzi M, Melissa B, Magrini E, Bini V, Appignani A. Laparoscopic herniorrhaphy in the pediatric age group: what about the learning curve? J Endourol. 2013;27(7):840-4.
18. Zhou J, Chen X, Jiang T. Pediatric inguinal hernia treated by single-port laparoscopic water injection hernia crochet needle. Wideochir Inne Tech Maloinwazyjne. 2020;15(1):239-44.
19. Maillet OP, Garnier S, Dadure C, Bringuier S, Podevin G, Arnaud A, et al. Inguinal hernia in premature boys: should we systematically explore the contralateral side? J Pediatr Surg. 2014;49(9):1419-23.
20. Gollu G, Ates U, Bahadir K, Ergun E, Yagmurlu A, Cakmak M, et al. Transinguinal laparoscopic evaluation of contralateral side during unilateral inguinal hernia repair for children. J Pediatr Urol. 2019;15(5):561 e1- e6.
21. Lee SL, Sydorak RM, Lau ST. Laparoscopic contralateral groin exploration: is it cost effective? J Pediatr Surg. 2010;45(4):793-5.
22. Balogh B, Hajnal D, Kovacs T, Saxena AK. Outcomes of laparoscopic incarcerated inguinal hernia repair in children. J Minim Access Surg. 2020;16(1):1-4.
23. Kaya M, Huckstedt T, Schier F. Laparoscopic approach to incarcerated inguinal hernia in children. J Pediatr Surg. 2006;41(3):567-9.
24. Bertozzi M, Marchesini L, Tesoro S, Appignani A. Laparoscopic herniorrhaphy in children. Pediatr Med Chir. 2015;37(2):pmc 2015 109.
25. Nah SA, Giacomello L, Eaton S, de Coppi P, Curry JI, Drake DP, et al. Surgical repair of incarcerated inguinal hernia in children: laparoscopic or open? Eur J Pediatr Surg. 2011;21(1):8-11.
26. Zhu H, Li J, Peng X, Alganabi M, Zheng S, Shen C, et al. Laparoscopic Percutaneous Extraperitoneal Closure of the Internal Ring in Pediatric Recurrent Inguinal Hernia. J Laparoendosc Adv Surg Tech A. 2019;29(10):1297-301.
27. Shalaby R, Ismail M, Dorgham A, Hefny K, Alsaied G, Gabr K, et al. Laparoscopic hernia repair in infancy and childhood: evaluation of 2 different techniques. J Pediatr Surg. 2010;45(11):2210-6.
28. Nevescanin A, Vickov J, Elezovic Baloevic S, Pogorelic Z. Laryngeal Mask Airway Versus Tracheal Intubation for Laparoscopic Hernia Repair in Children: Analysis of Respiratory Complications. J Laparoendosc Adv Surg Tech A. 2020;30(1):76-80.
29. Ozgediz D, Roayaie K, Lee H, Nobuhara KK, Farmer DL, Bratton B, et al. Subcutaneous endoscopically assisted ligation (SEAL) of the internal ring for repair of inguinal hernias in children: report of a new technique and early results. Surg Endosc. 2007;21(8):1327-31.
30. Li B, Nie X, Xie H, Gong D. Modified single-port laparoscopic herniorrhaphy for pediatric inguinal hernias: based on 1,107 cases in China. Surg Endosc. 2012;26(12):3663-8.
31. Grimsby GM, Keays MA, Villanueva C, Bush NC, Snodgrass WT, Gargollo PC, et al. Non-absorbable sutures are associated with lower recurrence rates in laparoscopic percutaneous inguinal hernia ligation. J Pediatr Urol. 2015;11(5):275 e1-4.