TY - JOUR
T1 - Variations in open and laparoscopic repair of paediatric inguinal hernia
AU - Olesen, Christoffer Skov
AU - Andersen, Kristoffer
AU - Öberg, Stina
AU - Deigaard, Søren Lykke
AU - Rosenberg, Jacob
N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
PY - 2020
Y1 - 2020
N2 - INTRODUCTION: No recent guidelines exist for surgical treatment of paediatric inguinal hernias. Internationally, there is disagreement about both the preferred approach and the details of the surgical procedure. The aim of this nationwide survey study was to assess variations in Danish surgeons' technique when repairing inguinal hernias in children.METHODS: A questionnaire was sent to all surgeons in Denmark performing paediatric inguinal hernia repair, including questions about demographic details, choice of open or laparoscopic repair, and technical details of the chosen surgical approach. In the questionnaire, each item was repeated for children aged les than 2, 2-12, and 13-18 years of age.RESULTS: In total, 48 of 59 surgeons responded (81%). For children 12 years of age, the majority of surgeons only performed open repair, whereas none performed laparoscopic repair only. For children aged 13-18 years of age, two thirds of the surgeons performed open repair only, 6% performed laparoscopic repair only and the rest used both methods. We found considerable variations in the execution of both open and laparoscopic repair. The variations regarded incision of the external fascia, nerve identification, division of the cremaster muscle, and exploration of the contralateral groin and repair of an asymptomatic hernia.CONCLUSIONS: This study found considerable variation in the execution of both open and laparoscopic repair of inguinal hernias in children of different age groups. Research into inguinal hernia repair in children is needed to rationalise and update guidelines in order to improve quality and facilitate research.FUNDING: none.TRIAL REGISTRATION: not relevant.
AB - INTRODUCTION: No recent guidelines exist for surgical treatment of paediatric inguinal hernias. Internationally, there is disagreement about both the preferred approach and the details of the surgical procedure. The aim of this nationwide survey study was to assess variations in Danish surgeons' technique when repairing inguinal hernias in children.METHODS: A questionnaire was sent to all surgeons in Denmark performing paediatric inguinal hernia repair, including questions about demographic details, choice of open or laparoscopic repair, and technical details of the chosen surgical approach. In the questionnaire, each item was repeated for children aged les than 2, 2-12, and 13-18 years of age.RESULTS: In total, 48 of 59 surgeons responded (81%). For children 12 years of age, the majority of surgeons only performed open repair, whereas none performed laparoscopic repair only. For children aged 13-18 years of age, two thirds of the surgeons performed open repair only, 6% performed laparoscopic repair only and the rest used both methods. We found considerable variations in the execution of both open and laparoscopic repair. The variations regarded incision of the external fascia, nerve identification, division of the cremaster muscle, and exploration of the contralateral groin and repair of an asymptomatic hernia.CONCLUSIONS: This study found considerable variation in the execution of both open and laparoscopic repair of inguinal hernias in children of different age groups. Research into inguinal hernia repair in children is needed to rationalise and update guidelines in order to improve quality and facilitate research.FUNDING: none.TRIAL REGISTRATION: not relevant.
KW - Adolescent
KW - Child
KW - Child, Preschool
KW - Denmark
KW - Female
KW - Health Care Surveys
KW - Hernia, Inguinal/surgery
KW - Herniorrhaphy/methods
KW - Humans
KW - Laparoscopy/statistics & numerical data
KW - Male
KW - Practice Patterns, Physicians'/statistics & numerical data
KW - Surgeons/statistics & numerical data
M3 - Journal article
C2 - 32285794
SN - 1603-9629
VL - 67
JO - Danish Medical Journal
JF - Danish Medical Journal
IS - 4
M1 - A12190687
ER -