A Comparative Study Between Open and Laparoscopic Herniotomy in Pediatric Age Group

Dr. Shubham Parashar, Dr. Rahul Sharma

Abstract: Background: Inguinal hernia is a highly prevalent surgical condition in children, traditionally managed by open herniotomy. With advances in minimally invasive techniques, laparoscopic herniotomy has gained prominence. This study aims to compare the outcomes of these two approaches to guide clinical decision - making for pediatric patients. Objectives: To compare operative time, incidence of intraoperative and postoperative complications, length of hospital stay, and patient/guardian satisfaction between open and laparoscopic herniotomy in children aged 1 month to 12 years. Methodology: This prospective, observational, and comparative study was conducted at the Department of General Surgery, Index Medical College, Indore. Pediatric patients scheduled for elective inguinal herniotomy were enrolled and allocated to either the open or laparoscopic group. Data collected included surgery duration, intraoperative and postoperative complications, and hospital stay. Patient/guardian satisfaction was assessed post - procedure. Ethical approval was obtained from the Institutional Ethics Committee (Ref. No.: IMCHRC/IEC/2023/52, dated 19.08.2023), and written informed consent was secured. Statistical analysis involved descriptive statistics (means, percentages, counts) due to the observational nature of the study, without formal inferential tests for statistical significance between groups. Results: Sixty pediatric patients (30 in each group) were included. The average operative time was 26 minutes for open herniotomy and 27 minutes for laparoscopic herniotomy. No intraoperative complications were observed in either group. Postoperative complications were rare, with 3 cases of wound infection in the open group and 1 wound infection and 1 pleural effusion in the laparoscopic group. The majority of patients (76%) were discharged within 1 day, with similar average hospital stays for both techniques (open: ~1.7 days; laparoscopic: ~1.4 days). Overall patient/guardian satisfaction was high (Open: 96.7%, Laparoscopic: 93.3%), with dissatisfaction linked to complications. Conclusion: Both open and laparoscopic herniotomy are safe and effective for inguinal hernia repair in children, showing comparable rates of postoperative complications, hospital stay, and high patient/guardian satisfaction. Laparoscopic herniotomy had a slightly longer operative time. The choice of technique should be individualized, considering factors such as surgeon experience, patient characteristics, and available resources.

Keywords: Pediatric, Herniotomy, Open surgery, Laparoscopic surgery, Inguinal hernia, Complications, Operative time, Hospital stay, Patient satisfaction