Inguinal Hernia

An inguinal hernia appears as a bulge or lump in the groin and scrotum (testicles) in boys, or in the groin and large labia (vulva) in girls. It occurs when a peritoneal protrusion that passes through the inguinal canal fails to close, creating a hernia sac into which abdominal contents may enter. In boys, the hernia sac typically contains part of the intestine, while in girls, it may contain either the intestine or the ovary. The bulge may not be noticeable when the child is lying down, but it can enlarge when standing, crying, or straining. An inguinal hernia can be unilateral or bilateral.

What does inguinal hernia surgery in children involve?  

The surgery is performed under general anesthesia.
The surgeon will make a small incision in the groin area, locate the hernia sac, and close it within the inguinal canal. The incision will be closed with resorbable sutures, meaning that the stitches will dissolve on their own during the healing process. The pediatric surgeon may also recommend a minimally invasive approach, i.e., laparoscopic surgery. Laparoscopic surgery is performed through a small incision in the belly button and two smaller incisions on both sides of the abdomen below the belly button, with the hernia sac being closed using laparoscopic instruments.

If your child has bilateral inguinal hernias, both sides can be treated simultaneously.

Why is inguinal hernia surgery necessary? 

When an inguinal hernia occurs, there is a risk of the contents (e.g., intestines) becoming trapped, which leads to a painful swelling. This can affect the blood supply to the intestines, potentially causing the affected part of the intestine to die.

Are there any other treatment options for inguinal hernia? 

There are no other treatment options for inguinal hernia.

What are the possible complications of inguinal hernia surgery?

The possible complications of this surgery are rare, but can include:

1. Bleeding in the wound area and the scrotum.
2. Wound infection: If the wound becomes red, painful, or discharges pus, contact your general practitioner or surgeon, who may prescribe antimicrobial therapy.
3. Recurrence of inguinal hernia, which may require a second surgery.
4. During laparoscopic surgery, there may be injury to intra-abdominal organs such as the intestines or bladder. This would be noticed during the operation and corrected immediately.

Specific complications in boys:

1. Injury to the spermatic cord. This should not affect your child’s growth or reproductive function if the contralateral spermatic cord remains open.
2. Injury to the blood vessels of the testis: This will cause reduced blood flow to the testis and potentially lead to testicular atrophy. However, this should not affect your child’s growth or reproductive function if the contralateral testis is functioning normally.
3. Retraction of the testis into the inguinal canal (scar tissue pulling the testis to the groin): This may require further surgery.

The surgeon will discuss possible complications and how to address them in more detail.