WOFAPS 2025 8th World Congress of Pediatric Surgery

Miri Tominaga, Hideaki Sato, Yu Watarai, Noriyoshi Nakayama, Ai Tayama, Shunsuke Osawa, Shota Kimura, Sei Adachi

Showa medecal university school of medicine, Department of Surgery, Division of pediatric surgery

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【Purpose】

Comparison of postoperative pain due to traditional open repair (OA) or laparoscopic procedures (LPEC) to repair pediatric inguinal hernia is difficult in patients aged < 5 years. This single institute study was performed to quantitatively evaluate pain associated with LPEC and OA.

【Methods】

Thirty-seven patients aged <5 years underwent inguinal hernia surgery between July 2024 and March 2025. We evaluated postoperative pain at 3 and 6 h using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale, which has been validated for use in children and provides 0–10 range scores.

【Results】

Twenty-four patients underwent OA and 13 underwent LPEC. OA and LPEC group FLACC scores were 0.78 and 0.62 at 3 h and 0.06 and 0.58 at 6 h, respectively, postoperatively.

Nineteen males underwent OA, and two males underwent LPEC. Among males, OA and LPEC group FLACC scores were 0.94 and 0 at 3 h and 0 both at 6 h postoperatively. Five females underwent OA and 11 females underwent LPEC. Among females, OA and LPEC group FLACC scores were 0.2 and 0.73 at 3 h and 0.25 and 0.7 at 6 h postoperatively.

Twenty-seven patients underwent unilateral surgery (23 OA and 4 LPEC). Among these patients, respective FLACC scores at 3 h were 0.74 and 0.25. At 6 h postoperatively, they were 0.06 and 0. Ten patients underwent bilateral surgeries (1 OA and 9 LPEC). Among these patients, respective FLACC scores at 3 h were 1 and 0.78. At 6 h postoperatively, they were 0 and 0.88.

【Conclusions】

The FLACC scale quantitatively revealed that bilateral OA and male OA were more painful at 3 h postoperatively, but more pain persisted at 6 h postoperatively among bilateral and female LPEC patients.

A larger study is required to verify these findings.