Systematic review and meta-analysis of laparoscopic versus open repair for pediatric incarcerated inguinal hernia

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Hernia : the journal of hernias and abdominal wall surgery Published May 12, 2026 Medically reviewed May 12, 2026 Study authors: Huang Huang, Wu Hongjun, Hou Longlong, Feng Shaoguang PubMed ↗ DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Consider laparoscopic repair as a safe and effective alternative to open repair for pediatric incarcerated inguinal hernia.

This systematic review and meta-analysis examined laparoscopic repair compared with open repair for pediatric incarcerated inguinal hernia. The analysis included 584 patients. The primary outcomes assessed were operative time, intraoperative blood loss, and length of hospital stay. Secondary outcomes included intraoperative injury, wound infection, testicular atrophy, and recurrence. The setting was not reported.

Laparoscopic repair was associated with significantly shorter operative time compared with open repair. Intraoperative blood loss was reduced in the laparoscopic group. Length of hospital stay was also significantly shorter with laparoscopic repair. The effect sizes were reported as pooled mean difference with 95% confidence interval for continuous outcomes and odds ratio with 95% confidence interval for binary outcomes. Absolute numbers were not reported.

For safety outcomes, the risk of intraoperative injury and recurrence was significantly lower with laparoscopic repair. There was no statistically significant difference between groups for wound infection or testicular atrophy. Serious adverse events were not reported. Discontinuations and tolerability were not reported.

The authors conclude that laparoscopic repair appears to be a safe and effective alternative to open repair for this condition. However, they state that further high-quality prospective studies are warranted to confirm these findings. Funding or conflicts of interest were not reported.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

PMID42118158

View Original Abstract ↓

PURPOSE: The optimal surgical approach for pediatric incarcerated inguinal hernia remains controversial. This study aimed to systematically compare the clinical outcomes of laparoscopic repair (LH) and open repair (OH) in children with incarcerated inguinal hernia through a systematic review and meta-analysis. METHODS: A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library from database inception to March 2026. Comparative studies evaluating LH versus OH in pediatric incarcerated inguinal hernia were included. Primary outcomes included operative time, intraoperative blood loss, and length of hospital stay. Secondary outcomes included intraoperative injury, wound infection, testicular atrophy, and recurrence. Pooled mean differences (MD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated using Review Manager 5.4. RESULTS: Nine studies involving 584 pediatric patients were included in the meta-analysis. Compared with OH, LH was associated with significantly shorter operative time and reduced intraoperative blood loss. The length of hospital stay was also significantly shorter in the LH group. In addition, LH showed a significantly lower risk of intraoperative injury and recurrence. No statistically significant differences were observed between the two groups in terms of wound infection or testicular atrophy. CONCLUSIONS: Laparoscopic repair appears to be a safe and effective alternative to open repair for pediatric incarcerated inguinal hernia. Further high-quality prospective studies are warranted to confirm these findings.