Pediatric Inguinal Hernia Surgeries Performed by Surgical Residents' Clinical Outcomes

Introduction

Programs for general surgery residents must include training in pediatric surgery, and residents should encounter a range of pediatric illnesses. The most frequent procedure is a pediatric inguinal herniorrhaphy, which involves fundamental surgical techniques such as skin incision, positioning in the inguinal canal, dissecting thin, frail hernia sacs free of surrounding tissues, suturing and ligating the sac, and layered wound closures. While inguinal herniorrhaphy is necessary for surgical training, it is also important that patients have safe and positive outcomes.

Numerous studies have evaluated postoperative patient outcomes for adult gastrointestinal surgery in comparison to surgical residents. A thorough analysis of the research found that, in the majority of cases, residents were not necessary to provide patients with safe and effective care. However, there hasn't been a good evaluation of how well pediatric procedures carried out by surgical residents are performed clinically. Only one study made the claim that the presence of surgical residents had no bearing on the postoperative complications of pediatric laparoscopic appendectomy. The purpose of this study was to evaluate the clinical results of pediatric inguinal hernia repairs done by surgical residents and the validity of surgical training. Even if the surgeon was a surgical resident, the incidence of postoperative surgical complications and recurrence in pediatric inguinal hernia surgeries did not rise. That compared to senior residents, adult inguinal hernia repairs, made by junior residents had greater recurrence rates. 

Operations

For anterior inguinal hernia surgeries under general anesthesia, Potts' technique, which involves dividing and high ligating the hernia sac, has become the accepted standard surgery. Internal inguinal ring closure may occasionally be applied when high hernia sac ligation is challenging, as in cases of sliding ovarian hernia. Surgery residents always worked under the guidance of attending surgeons during all procedures. Circulating nurses recorded the length of time it took from the start of the skin incision to the end of the wound dressing.

Operation-Specific Anesthesia

all procedures were carried out under general anesthesia, and each patient was assigned to a class based on their physical status as defined by the American Society of Anesthesiologists (ASA-PS). This study regarded postoperative nausea and vomiting (PONV) and postoperative fever as anesthetic complications. We looked at the impact of anesthetic. The extended duration of general anesthesia in the SR group did not result in an increase in postoperative anesthesia complications including PONV and fever. Overall, the surgical and anesthesia-related complication rates as well as the recurrence rate were unaffected by the surgical residents' participation in hernia surgery.

Inguinal Hernia Recurrence and Surgical Complications Following Surgery

Data on the postoperative surgical complications of spermatic cord edema, hematoma, hemorrhage, and surgical site infection were retrieved. A case requiring a second procedure was described as an inguinal hernia recurrence. Surgical residents must do a sufficient number of operations because one of the objectives of surgical residency training programs is to develop technically proficient surgeons. To get the board certification for general surgeons, they must have at least pediatric operations under their belts. They practice many pediatric inguinal hernia procedures as an operator during their months-long rotation in the pediatric surgery department at our hospital. During their rotation in pediatric surgery, general surgical residents in the US underwent more than half of inguinal and umbilical hernia procedures. High-quality surgical outcomes are required even if the surgeon is still in training. The demographics of the patients revealed that the inguinal hernia surgeries made by attending surgeons appeared to be more difficult since the AS group's imprisonment rate was significantly greater than the SR group's. However, the AS group's anesthetic and surgical times were considerably less than those of the SR group. Longer operating times were closely correlated with longer anesthetic times. Only a small number of research have examined the length of pediatric surgical operations. When compared to the term without rotating surgical residents, the amount of time spent operating on kids with inguinal and umbilical hernias increased dramatically. Statistically speaking, surgical residents took longer to complete a pediatric laparoscopic appendectomy than attending surgeons did.

Journal Information

The Journal of Surgical Research is an academic, interdisciplinary journal that serves as a venue for the publication of scientific manuscripts based on innovative surgical interventions for the treatment and/or management of abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery, or research advancements corresponding to the development of advanced medical tools and techniques, which in turn may help in completing challenging surgical procedures.

*The “Journal of Surgical Research”.

Publishes current research articles related to Surgery.

Manuscript Submission link: https://www.pulsus.com/submissions/pulsus-surgical-research.html