Inguinal Hernia Repair in Pediatric Surgery Subspecialty Training: Safety and Clinical Outcomes of Open and Laparoscopic Surgery Performed by Trainees

Introduction Inguinal hernia repair is essential in pediatric surgery training; however, few studies have examined the safety and outcomes of the procedure when performed by trainees. This study aimed to clarify the safety and clinical outcomes of open repair, laparoscopic percutaneous extraperitoneal closure (LPEC), and single-incision LPEC (SILPEC) for inguinal hernias in children, when performed by pediatric surgery trainees. Methods This single-center, retrospective cohort study included children aged <16 years who underwent conventional open repair, LPEC, or SILPEC for inguinal hernia between September 2015 and August 2023; patients who had comorbidities or underwent other procedures were excluded. Patient demographics, operative data, intraoperative and postoperative complications, and hernia recurrence were collected from medical records and analyzed. Results A total of 709 patients were eligible. Pediatric surgery trainees performed 325/372 (88%), 143/196 (73%), and 73/141 (52%) open, LPEC, and SILPEC procedures, respectively. Intraoperative complication rates (trainees vs. attending surgeons) were comparable between the open, LPEC, and SILPEC procedures (0% vs. 0%, p = 1.00; 0% vs. 0%, p = not available; 0% vs. 2%, p = 0.45, respectively). The postoperative complication rates (trainees vs. attending surgeons) were also similar between the open, LPEC, and SILPEC procedures (5% vs. 4%, p = 1.00; 6% vs. 8%, p = 0.86; 7% vs. 13%, p = 0.32, respectively). Hernia recurrence was not observed in any procedure. Conclusion Inguinal hernia repair performed by pediatric surgery trainees was not associated with increased intraoperative or postoperative complications. The clinical outcomes were favorable, with no hernia recurrence in open, LPEC, or SILPEC procedures, even when performed by pediatric surgery trainees.