Laparoscopy is increasingly used for pediatric inguinal hernia repair

• Published in: Journal of pediatric surgery Vol. 56; no. 11; pp. 2016 - 2021
• Main Authors: Shaughnessy, Matthew P., Maassel, Nathan L., Yung, Nicholas, Solomon, Daniel G., Cowles, Robert A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2021
• Subjects: Inguinal hernia repair; Laparoscopy; Pediatric health information system; Pediatric surgery; Trends; IHR; LIHR; Pediatric surgery; CPT; Inguinal hernia repair; PHIS; TIHR; Laparoscopy; Trends; CHA; Pediatric health information system
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2021.01.032

Inguinal hernia repairs (IHR) are commonly performed by pediatric surgeons in the United States. The operative approach depends on surgeon preference with no definitive prospective studies comparing laparoscopic inguinal hernia repair (LIHR) versus traditional inguinal hernia repair (TIHR). We aim to assess current practice, hypothesizing that laparoscopy is increasingly used for pediatric IHR. The Children's Hospital Association (CHA) Pediatric Health Information System was queried for IHRs performed between 01/01/2009 and 12/31/2018. Demographics, procedure type, hernia laterality, and cost were obtained. Patients were grouped by procedure type (laparoscopic/traditional). 125,249 IHRs were performed at 32 CHA hospitals during the ten-year study period. 115,782 (92.4%) were TIHR and 9467 (7.6%) LIHR. Use of laparoscopy increased 5-fold from 3% to 15% over the study period. When comparing laparoscopic to traditional IHR groups, there were more females (28.3% vs 12.6%), African-Americans (19.7% vs 14.4%), government-insured (50% vs 45.2%), younger patients (4.2 vs 4.4 years), bilateral IHRs (11.4% vs 7.9%), and higher adjusted total hospital cost ($3,791 vs $2995) in the laparoscopic group (p<0.0001, all comparisons). Laparoscopy for pediatric IHR is increasing at CHA hospitals where nearly 1 in 6 children currently undergoes a laparoscopic repair. The long-term outcomes with laparoscopic repair are worthy of future study.