3 National Survey of Consultant and Trainee Paediatric Surgeons regarding the use of and attitudes towards laparoscopic inguinal hernia repair.
Rohini Sahay, GV Murthi
Sheffield Children's Hospital, Sheffield, United Kingdom


Aims : We report the findings of a national survey of UK Paediatric Surgery Consultants and Trainees about the current situation in clinical practice regarding: attitudes, concerns, audit, training issues in relation to the use of laparoscopic repair of inguinal hernia.

Methods: A Surveymonkey questionnaire was circulated to the BAPS mailing list after approval by BAPS Scientific Committee; Trainees were contacted via the TRIPS forum.

Results: There were 82 respondents (73 complete). Findings are summarised in Table 1.

Conclusions: About 7000 operations for inguinal hernia are performed in children annually according to NHS Hospital Episode Statistics(HES); 50% are in infants-80% in males. Patient Choices and Getting It Right First Time (GIRFT) recommend that patients be offered all available treatment options to choose from. With 50% of centres/consultants not offering the laparoscopic option, parents/patients are denied this opportunity. On the other hand, concerns regarding the safety and efficacy of the laparoscopic approach, lack of training/infrastructure need to be addressed, perhaps through a national study.

Table 1: Main results of the survey; ‘%’ – indicates proportion of respondents


82 (73 completed survey)

>10 years experience


>25 hernia repairs/ year


Experienced laparoscopist


Centre offers laparoscopic option?


Audit undertaken?

63%; 24% showed laparoscopic outcome poorer

Which is better?

50% felt open repair is better

Need to see more evidence of benefit for laparoscopy


Main concerns regarding laparoscopy?

  • Recurrence higher – 60%
  • Higher operating time – 64%
  • Higher cost – 36%
  • Vas/vessel injury – 25%

Lack of training/infrastructure to offer laparoscopy


What would increase uptake of the laparoscopic approach?

  • More evidence of benefit (53%)
  • Learning opportuity (11%)
  • Unwilling to change (42%)


  • Would like to be trained (80%)
  • Consultant support (97%)
  • Unsure of relative benefits (62%)
  • Untrained in laparoscopic method (27%)