# BOB Ped Surg 2023 - Wendy Song, CAPS - Presentation — GCMD Library

Watch Wendy Song, MD, present her presentation on "A comparison of operative and anesthetic techniques for inguinal hernia repair in infants."

Type: video · posted 2023-02-06 Canonical: https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352 ## Chapters - [0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=0) Introduction and Background - [2:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=120) Study Methodology - [3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=180) Results: Complications and Outcomes - [4:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=240) Results: OR Utilization - [5:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=300) Conclusions and Limitations ## Statements - "Inguinal hernia repairs are some of the most common pediatric surgical procedures and are traditionally performed under general anesthesia for open surgery" — Wendy (clinical) [0:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=0) - "Many centers have recently started utilizing the minimally invasive approach with regional anesthesia instead of traditional general anesthesia with open surgery" — Wendy (clinical) [1:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=60) - "Over the last five years at BC Children's Hospital, surgeons and anesthesiologists have utilized four different combinations of surgical and anesthetic techniques" — Wendy (clinical) [1:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=90) - "The safety of caudal anesthesia with laparoscopy (CL) was demonstrated in a prior case study" — Wendy (clinical) [2:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=120) - "The CL technique has previously not been described in literature for comparison with other approaches" — Wendy (clinical) [2:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=150) - "The study included all infants less than one year old undergoing elective inguinal hernia repair from July 2016 to 2021 at a single tertiary care teaching center" — Wendy (clinical) [3:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=180) - "Inguinal hernia repairs with concomitant procedures and emergent procedures from strangulated or incarcerated hernias were excluded from the study" — Wendy (clinical) [3:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=210) - "Eight surgeons and 25 anesthesiologists contributed patients with approach dictated by practitioner preference" — Wendy (clinical) [4:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=240) - "465 infants were initially assessed for eligibility of which 338 patients were included in the final study analysis" — Wendy (clinical) [4:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=270) - "Most patients underwent an open procedure with only 63 cases being laparoscopic" — Wendy (clinical) [5:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=300) - "There was a relatively even split between caudal anesthesia and general anesthesia" — Wendy (clinical) [5:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=330) - "Most included patients were pre-term males and were followed for a median of 2.5 years" — Wendy (clinical) [6:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=360) - "There were two crossovers: one conversion in the GL group to open surgery because the patient was unable to tolerate the pneumoperitoneum" — Wendy (clinical) [6:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=390) - "One case required conversion to general anesthesia in the caudal group because the patient did not tolerate the incision despite initially passing the pinch test" — Wendy (clinical) [7:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=420) - "There was no statistical difference found between groups for the aggregate post-operative complication rates, including recurrence" — Wendy (clinical) [7:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=450) - "Metachronous hernias occurred at a similar rate for open and laparoscopic approaches, albeit with a modest follow-up irrespective of anesthetic choice" — Wendy (clinical) [8:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=480) - "Total OR time was significantly different between groups with caudal anesthesia with open surgery being the shortest" — Wendy (clinical) [8:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=510) - "Caudal anesthesia with open surgery was significantly shorter than caudal anesthesia with laparoscopy by 15 minutes" — Wendy (clinical) [9:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=540) - "Caudal anesthesia with open surgery was significantly shorter than general anesthesia with open surgery by 9 minutes" — Wendy (clinical) [9:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=570) - "There was no difference in anesthetic preparation time or skin to skin time between the groups" — Wendy (clinical) [10:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=600) - "Overall post procedure time was significantly shorter in patients receiving a caudal blockade than general anesthesia, with four minutes saved in the laparoscopic group" — Wendy (clinical) [10:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=630) - "Overall post procedure time was significantly shorter in patients receiving a caudal blockade than general anesthesia, with eight minutes saved in the open group" — Wendy (clinical) [11:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=660) - "The use of laparoscopy with caudal anesthesia appears to be a safe and effective option in terms of post-operative complications compared to other groups" — Wendy (opinion) [11:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=690) - "Caudal anesthesia with open surgery appeared to be the most resource efficient inguinal hernia repair method" — Wendy (opinion) [12:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=720) - "Due to the retrospective nature of the project, it is subject to the normal bias of any retrospective review" — Wendy (opinion) [12:30](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=750) - "Due to lack of cross hospital EMRs, the study follow-up was unable to capture post-operative complications managed at any other hospital or clinic" — Wendy (clinical) [13:00](https://library.globalcastmd.com/watch/bob-ped-surg-2023-wendy-song-caps-presentation-6352?t=780) --- Not medical advice · citation policy: https://library.globalcastmd.com/ai