A Clinical Comparison Of Laparoscopic High Ligation And Open High Ligation Of Hernia In Children

Objective:To evaluate the clinical application of Laparoscopy in Pediatric Inguinal Hernia Surgery.Methods:In a prospective study between November 2018 and November 2019,80 children with diagnosis of Primary Inguinal hernia,who fall under inclusion criteria were selected and underwent either LS(40)or OS(40)in the affiliated hospital of Inner Mongolia Hospital of Inner Mongolia University for nationalities.All the patients were treated with surgical procedure with primary inguinal hernia and excluding Patients with other diseases like Strangulated hernia and incarcerated hernia,Non-reducible,Recurrent hernia,bilateral hernia and previous lower abdominal Surgery/Radiotherapy.Operation time,blood loss intra-operative and postoperative complications,postoperative pain,postoperative stay,cosmesis,and the size of testis were recorded and compared for differences in outcome.Patients were followed up for an average of 3.5 months.The data were analyzed by SPSS 20.0 statistical software.The measurement was done with(mean±standard deviation),t-test and chi square(X2)test.The difference was statistically significant with P<0.05.Results:All the cases selected for the study was with unilateral hernia only among which,out of 40 cases in open surgery 38(95%)were male and 2(5%)were female.Likewise out of 40 cases in laparoscopic group,35(87.5%)were male and 5(12.5%)were female.LS was found quicker than OS to perform[16.73 min Vs 19.23 min(P<0.05)].The difference in pain perception,between LS and OS,was insignificant Recovery was quicker in laparoscopic surgery than in open surgery,and the duration of hospital stay was shorter in LS[2.053±0.221 Vs 3.10±0.379 days(P<0.05).Complication rates were similar(P=0.432).Cosmesis in LS was superior to that in OS.Conclusion:Well-performed conventional herniotomy yields results similar to those of laparoscopic repair.Hospital stay and recovery time is relatively low in case of laparoscopic repair and time taken for laparoscopic repair was also comparatively low as the surgeons were well experienced.Cosmesis and the ability to detect and simultaneously repair CPPV are the 2 main advantages of LS over OS.Keeping in mind the low incidence of meta-chronicity in UL hernias,insignificance of cosmesis over the groin,and the constraints of the developing world,conventional open herniotomy can justly be performed for UL hernias,as the standard of care,in centers lacking laparoscopy.