What is inguinal hernia surgery?
Inguinal hernia repair is one of the most frequent surgical procedures in the pediatric age group. Unlike what happens in adults, infantile inguinal hernias are congenital, that is to say, they are present from birth, although in some cases it takes time for them to become evident.
They are caused by a lack of closure of a communication that exists in the inguinal canal with the abdomen during fetal development. In our environment, they appear in approximately 2-5% of children and are more frequent in premature or low birth weight infants. It is more common to find them on the right side and although they can affect both sexes, they are more frequent in boys.
When is surgery indicated?
Inguinal hernia repair in children is always indicated from the moment of diagnosis, regardless of the patient’s age. This is because inguinal hernia in pediatric patients can cause problems, especially in children under 1 year of age.
The main complication is the incarceration or strangulation that occurs when a fragment of intestine is introduced into the hernia and this is trapped without being able to return to the abdomen, which requires urgent action and can lead to more serious complications.
How is this type of surgery performed?
The intervention consists of closing the communication that was left open in the fetal period, separating and removing the hernia sac from the rest of the structures that accompany it by means of a small wound in the groin.
When they are bilateral, that is, when the patient has an inguinal hernia on each side, a laparoscopic procedure may be indicated. In this case, a camera is introduced through the umbilicus and this communication is closed from the abdomen on both sides.
In children, mesh placement is not indicated and this simple procedure is sufficient in most cases to solve the problem.
The operation is performed in the operating room under general anesthesia, although local and/or regional anesthesia is also administered to make the postoperative period as comfortable as possible.
This procedure is usually done on an outpatient basis, without the need to spend the night in the hospital. Hospitalization for at least 24 hours may be necessary in some cases: if the patient has any additional pathology, lives far away from a health center or in small infants requiring close observation.
What are the risks for the patient?
In general, it is a safe procedure as long as it is performed by personnel accustomed to the surgical treatment of pediatric patients. There are very few complications derived from the surgery and these are infrequent. The most notable complications are those of the surgical wound such as:
- Infection
- Bleeding
- Suture opening
These complications are usually minor and are treated and solved in a simple way (for example, with cures or administration of antibiotics). In a healthy patient, it is rare for the hernia to re-disappear on the operated side.
What care should be followed after the operation?
Postoperative care of an inguinal hernia is very simple. It consists of keeping the surgical wound clean by washing it every day with soap and water, avoiding prolonged baths. In addition, a topical antiseptic can be applied once a day. Intradermal resorbable stitches are usually used, so they do not need to be removed.
During the first 2-3 days it is recommended to administer a prescribed analgesic such as paracetamol to avoid discomfort.
In older children, we recommend not playing sports or swimming in pools for at least 3 weeks or until healing is complete.