A Single-Blinded, Randomized Comparison of Laparoscopic Versus Open Hernia Repair in Children

OBJECTIVE. The role of laparoscopic surgery in pediatric inguinal hernia repair is unclear. We aimed to compare day-case laparoscopic hernia repair with open repair. METHODS. A prospective, single-blinded randomized study in children aged 4 months to 16 years with unilateral inguinal hernia was performed. The primary outcome measure was the time to normal daily activities after surgery. Secondary outcome measures included postoperative pain, time in the operation room, results, and complications. RESULTS. Eighty-nine patients were enrolled (laparoscopic hernia repair: 47, open repair: 42). The mean number of days to normal activity after laparoscopic hernia repair and open repair was 2.4 and 2.5, respectively. Thirty-seven (79%) patients with laparoscopic hernia repair and 20 (42%) with open repair required rescue analgesia postoperatively. The median pain score in the second postoperative morning was significantly higher after laparoscopic hernia repair. The median times in the operation room for laparoscopic hernia repair and open repair were 63 and 38 minutes, respectively. Surgical and cosmetic results were similar at up to 2 years' follow-up. CONCLUSIONS. Recovery and outcome were similar after open repair and laparoscopic hernia repair in children. Laparoscopic hernia repair was associated with increased theater time and postoperative pain. Pediatrics 2009;123:332-337