Laparoscopic versus open repair for inguinal hernia in children: a retrospective cohort study

Surg Today. 2019 Dec;49(12):1044-1050. doi: 10.1007/s00595-019-01847-0. Epub 2019 Jul 16.


Purpose: We compared the outcomes of laparoscopic surgery (LS) with those of open surgery (OS) for unilateral and bilateral pediatric inguinal hernia.

Methods: Using a nationwide claim-based database in Japan, we analyzed data from children younger than 15 years old, who underwent inguinal hernia repair between January 2005 and December 2017. Patient characteristics, incidence of reoperation, postoperative complications, length of hospital stay, and duration of anesthesia were compared between LS and OS for unilateral and bilateral hernia.

Results: Among 5554 patients, 2057 underwent LS (unilateral 1095, bilateral 962) and 3497 underwent OS (unilateral 3177, bilateral 320). The incidence of recurrence was not significantly different between OS and LS (unilateral: OS 0.2% vs. LS 0.3%, p = 0.44, bilateral: OS 0.6% vs. LS 0.6%, p = 1.00). The incidence of metachronous hernias was significantly higher in the OS group than in the LS group (4.8% vs. 1.0%, p < 0.001). The surgical site infection rate was significantly lower after OS than after LS for unilateral surgeries (0.9% vs. 2.2%, p = 0.002). There was no difference between OS and LS in the length of hospital stay.

Conclusion: Both OS and LS had a low incidence of recurrence in children; however, the incidence of metachronous hernias was lower for LS, which may influence operative technique decisions.

Keywords: Contralateral metachronous inguinal hernia; Laparoscopic hernia repair; Pediatric inguinal hernia; Pediatric surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Anesthesia / statistics & numerical data
  • Child
  • Child, Preschool
  • Cohort Studies
  • Databases, Factual
  • Female
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy / methods*
  • Humans
  • Incidence
  • Infant
  • Japan
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Male
  • Postoperative Complications / epidemiology
  • Recurrence
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Surgical Wound Infection / epidemiology
  • Treatment Outcome