pediartic hernia

Inguinal Hernia

Inguinal hernia is the most common surgical problem of childhood. It results from a small sac that comes through the inguinal ring that is normally open during fetal life and closes around the time of birth. For reasons we don't understand, it does not close in some infants. This sac then makes a pathway for abdominal organs to come through the inguinal ring into the groin. In boys, the organ is usually a loop of bowel and, in girls, it may be bowel or an ovary. In boys and girls, the hernia first appears as a bulge in the groin, and may appear and disappear, or may be present all the time. It will usually "pop out" when the child cries or strains. If only fluid comes through the inguinal ring into the sac, the problem is called a hydrocele.

Why does my child need surgery?

Inguinal hernias never go away without treatment. Furthermore, if the sac is left open, a loop of bowel or other organ may become trapped or incarcerated (strangulated) in the sac. Once trapped, the organ, which comes through this very small opening, can swell and compress the blood supply that is pulled along with it. Without adequate blood supply, the organ trapped in the hernia sac can become damaged or even die. If your child has an incarcerated hernia, he or she may have a hard, red, painful lump, may vomit, may be unwilling to eat and may stop stooling. This is an emergency. If this happens, your child should be taken to your pediatrician's office or, after hours, to the local emergency room. The pediatrician or emergency room doctors will contact us. If the hernia cannot be pushed back (reduced) into the abdominal cavity, your child will need immediate surgery.

What does the surgery involve?

The surgery takes about one hour. Your child's pediatric surgeon will close the opening to the hernia sac laparoscopically, using small instruments through 2 or 3 tiny incisions.

In some children, the hernia sac will need to be closed through a very small (about one inch) incision in the groin. This is called an "open" operation. The pediatric surgeon will tell you which approach is best for your child. Children less than one year of age, can have an open sac on the other side that could become a hernia later. Your child's surgeon may use a tiny telescope to look for a hernia on the opposite side and close it if there is one. The surgeon will discuss this with you before the operation. There will be no stitches to remove from the skin later because the stitches will all be under the skin and will dissolve on their own. Your child's skin will be covered with small bandages called Steri-strips®.

How long will my child stay in the hospital?

After the operation your child will return back to the recovery area, and you can be with him or her while he or she is waking up. Some children are upset and confused as the anesthesia starts wearing off. This is temporary and not unusual. Most children will go home as soon as they are awake and able to drink liquids after the operation. If your child was born prematurely, or has other health problems, the surgeon may keep him or her in the hospital overnight to monitor his or her breathing.