Management of paediatric hernia
BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4484 (Published 19 October 2017) Cite this as: BMJ 2017;359:j4484All rapid responses
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I congratulate the authors on a fair, balanced, well-referenced (n = 29) article.
Two points caught my eye, which deserve comment.
Firstly, there is an un-referenced suggestion that laparoscopic repair of umbilical hernia is available. In adults this may be true, consisting typically of internal fixation of a non-absorbable mesh but this is something which is almost never required or indeed seen in children. Incidentally, umbilical hernias can be caused by laparoscopic access as this is the principle site of the largest camera port but actual repair in children I am not sure about.
Secondly, the accompanying illustration in the paper version of a gaudy false colour X-ray of a congenital diaphragmatic hernia (blue and orange??) is completely unnecessary. I suspect this is an addition by a BMJ sub-editor trying to catch the eye but it has nothing to do with the subject of your article.
Competing interests: No competing interests
Response to Mr M. Davenport
Many thanks for your reponse to your article. In our research regarding laparoscopic repair of umbilical hernia there was no evidence which we felt was robust enough to be referenced and so we had to rely on anecdotal evidence from paediatric surgeons. Although we were informed of some surgeons performing this procedure it is by no means common or standard practice and we may have simply identified the rare outliers to umbilical hernia repair methods.
As you imply in your response, several editorial changes are usually made between final submission and publication in order to ensure the article fits with the overall style and tone of the journal. It is therefore often felt by editorial staff that related images may be beneficial to aid the audiences' understanding which is not always in keeping with the authors original submission.
Competing interests: No competing interests