# A Retrospective Nationwide Comparison of Laparoscopic vs Open Inguinal Hernia Repair in Children — GCMD Library

<i>Michela Carter, Steven T Papastefan, Yao Tian, Stephen J Hartman, Meredith S Elman, Sara G Ungerleider, Aaron P Garrison, Tolulope A Oyetunji, Matthew P Landman, Mehul V Raval, Seth D Goldstein, Timothy B Lautz </i><div><i><br></i></div><div><b>Background:</b> Utilization of the laparoscopic approach for inguinal hernia repair has increased significantly over the past decade. The purpose of this study is to compare rates of second hernia operation and same side recurrence following open and laparoscopic inguinal hernia repair in a large national cohort.</div><div><br></div><div><b>Methods:</b> This retrospective analysis utilized the Pediatric Health Information System database to identify children <18 years-old who underwent laparoscopic or open primary inguinal hernia repair from 2017 to 2021. Data were collected through 2022 to allow minimum one year follow-up. Second hernia operation rates, inclusive of same side recurrence and metachronous contralateral hernia, and same side recurrence rates were compared by multivariable mixed effects model controlling for confounders and institutional clustering. Misclassification rates were determined through data validation at four constituent institutions. Sensitivity analyses determined true outcome rates.</div><div><br></div><div><b>Results:</b> We identified 53,287 operations (15.6% laparoscopic). Rate of second hernia operation was greater following laparoscopic repair (2.9% vs 2.6%, p = 0.04) with no difference on multivariable analysis (OR 1.14, 95% CI 0.98-1.32). Same side recurrence rate was greater following laparoscopic repair (1.5% vs 0.4%, p < 0.001) which persisted on multivariable analysis (OR 3.72, 95% CI 2.90-4.78). Sensitivity analysis demonstrated true laparoscopic and open repair rates of 14.2% and 85.8%, respectively. True rates of second hernia operation and same side recurrence were identical to those determined by PHIS.</div><div><br></div><div><b>Conclusion:</b> Laparoscopic inguinal hernia repair in children has more than three times the odds of same side hernia recurrence than open repair which is balanced by a reduced rate of second operation for metachronous hernia.</div>

Type: video · 0 min · posted 2026-02-17
Canonical: https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527

## Chapters
- [0:00](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=0) Laparoscopic vs Open Inguinal Hernia Repair in Children

## Statements
- "The study examined over 53,000 children who had inguinal hernia repair across the United States" — Lizzie Lee (epidemiological) [0:06](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=6)
- "Approximately 16% of the children had laparoscopic surgery" — Lizzie Lee (epidemiological) [0:13](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=13)
- "Most children had an open repair" — Lizzie Lee (epidemiological) [0:15](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=15)
- "The study compared two key outcomes: hernia recurrence on the same side and the need for a second hernia operation later on" — Lizzie Lee (clinical) [0:17](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=17)
- "Laparoscopic repair had more than 3 times the risk of same side recurrence compared to open surgery" — Lizzie Lee (clinical) [0:23](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=23)
- "Laparoscopic repair was linked to fewer future surgeries on the opposite side (metachronous hernias)" — Lizzie Lee (clinical) [0:30](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=30)
- "The findings held up even after adjusting for hospital differences and patient factors" — Lizzie Lee (clinical) [0:36](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=36)
- "Open repair has a lower risk of recurrence" — Lizzie Lee (clinical) [0:40](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=40)
- "Laparoscopic repair may reduce the chance of needing surgery on the other side" — Lizzie Lee (clinical) [0:40](https://library.globalcastmd.com/watch/a-retrospective-nationwide-comparison-of-laparoscopic-vs-open-inguinal-hernia-repair-in-children-11527?t=40)

## Transcript
Open or laparoscopic hernia repair, which is better for kids? I'm Lizzie Lee from Cincinnati Children's, and this is an article you should know about. This nationwide study looked at over 53,000 children who had inguinal hernia repair across the United States. About 16% had laparoscopic surgery. While most had an open repair. Researchers compared two key outcomes, hernia recurrence on the same side and the need for a second hernia operation later on. They found that laparoscopic repair had more than 3 times the risk of same side recurrence compared to open surgery. However, laparoscopic repair was linked to fewer future surgeries on the opposite side, known as metachronous hernias. These findings held up even after adjusting for hospital differences and patient factors. Bottom line, open repair has a lower risk of recurrence, while laparoscopic repair may reduce the chance of needing surgery on the other side. Let us know what you think in the comments below and stay tuned for more articles that you should know about.

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Not medical advice · citation policy: https://library.globalcastmd.com/ai