Development of Taxi Teaching for Strangled Inguinal Hernias in Children

Development of Taxi Teaching for Strangled Inguinal Hernias in Children

Inguinal hernias in children are very common but pose a risk of strangulation, which, if not treated quickly, can lead to life-threatening complications (intestinal obstruction, peritonitis) or functional complications (testicular ischemia). The manual reduction of a strangulated inguinal hernia, known as taxis, is often unfamiliar to the first doctors to see the child, whether they are general practitioners, pediatricians, or emergency physicians, and therefore requires second- or third-line treatment, which prolongs the delay in care and increases the risk of serious complications. The hypothesis is that targeted professional training using mannequins to practice this reduction maneuver for the doctors concerned would reduce the time required for reduction and thus improve the care of these patients. To this end, and in the absence of a dedicated model on the market for medical education through simulation, investigatores are developing a pediatric manikin to train doctors in performing hernia reduction maneuvers.

The aim of this study is therefore to compare the care pathway for children with strangulated inguinal hernias before and after training on mannequins for doctors in therapeutic taxis, in order to demonstrate in real life the impact of procedural training through simulation on improving patient care.

The objective is to show that a better understanding of hernia reduction techniques by frontline physicians leads to a reduction in the time taken to reduce strangulated inguinal hernias in children consulting for this reason. Investigators will therefore compare the time taken to reduce the hernia before and after the doctors concerned learned the reduction procedure, in the population of children treated for strangulated inguinal hernias in a pediatric surgery department of the HUGO network (Hôpitaux Universitaire du Grand Ouest - University Hospitals of western France). The study will therefore be divided into two phases: an initial retrospective, multicenter phase covering the period prior to the training of physicians in hernia reduction techniques, followed by a prospective, multicenter phase covering the period after training.

Inclusion Criteria:

• Any child (pediatric population defined as under 16 years of age) presenting at a university hospital or hospital in western France with a clinical diagnosis of strangulated inguinal hernia

Exclusion Criteria:

• Refusal to participate in the search for legal representatives
• Differential diagnosis of strangulated inguinal hernia (adenopathy, cord cyst, cryptorchid testicle, unstrangulated hernia)
• Patients and/or parents who do not speak French
• Patients not affiliated with a social security system.