Treatment of inguinal hernia in children.

Watch Prof. Dr. Mohamed Elbarbary explain:

Many parents believe that an inguinal hernia is caused by straining or excessive crying—this is entirely incorrect. A hernia is a congenital defect that has nothing to do with a child’s behavior. I always distinguish between two types: A “well-behaved” (reducible) hernia, where the contents move freely and return on their own. And a “strangulated” hernia, in which the intestines, testicle, or ovary in girls become trapped—the latter is an emergency situation that may cause permanent damage. For this reason, I do not recommend waiting until the child “gets stronger.” Even in premature infants or those with heart problems, planned surgery in a safe and controlled environment is always safer than emergency surgery in the middle of the night.

An inguinal hernia in children results from the protrusion of a portion of the intestine through the inguinal canal, which extends from the abdomen to the genitals.

Inguinal hernias are common in newborn males. especially those born before the 37th week of pregnancy. It usually appears as a bulge that parents notice when the child cries. Surgery is considered the only option for its treatment.

In this article, we will learn about how to surgically treat inguinal hernia in children, the success rate of this procedure, and the instructions that parents must follow during the recovery period.

Why should the inguinal hernia surgery for newborns be performed quickly?

The child must undergo surgery immediately upon confirmation of an inguinal hernia to avoid its health complications, the most dangerous of which is a strangulated hernia.

Strangulation occurs as a result of the interruption of the blood supply to the hernia contents. This leads to permanent damage and death of the intestine (gangrene), which threatens the child’s health.

The child with a strangulated hernia suffers from the following symptoms:

• Fever.
• Bloating.
• Stiffness at the site of the hernia and difficulty in pushing it back to its natural position.
• Excessive crying of the child.
• Nausea and vomiting.
• Redness at the site of the inguinal hernia.
• Inability to pass stool or gas.

Learn about: The reasons behind Inguinal Hernia

What exactly are the steps of the inguinal hernia surgery?

Laparoscopic repair of the inguinal hernia is preferred, as it is performed with minimal surgical intervention through several small incisions in the abdomen, which contributes to speeding up the recovery time from the surgery and reduces its complications.

The steps for surgically treating an inguinal hernia in children proceed as follows:

• Administering general anesthesia to the child.
• Making a few small surgical incisions in the abdominal area.
• Inserting the laparoscope, which consists of a thin tube equipped with a camera and a light source, through one of the incisions.
• Repairing the hernia using surgical tools until the intestines return inside the abdomen.
• Strengthening the weak area in the abdominal wall using a small synthetic mesh to prevent hernia recurrence.

How long does the inguinal hernia surgery take?

Pediatric inguinal hernia surgery takes between 20 and 35 minutes. This duration may vary depending on several factors, Most notably the surgeon’s skill and the type of hernia being treated.

Duration of inguinal hernia surgery in children and the factors affecting it

Pediatric inguinal hernia surgery duration ranges between 25 and 30 minutes, based on the following factors:

• The surgeon’s skill and experience.
• The degree of the hernia.
• The child’s general health condition.
• The type of anesthesia used in the surgery.

Does treating inguinal hernia in children surgically require a hospital stay?

After undergoing inguinal hernia surgery, the child remains in the hospital for approximately two hours to monitor their condition and ensure their vital signs are stable, then returns home on the same day of the surgery.

In cases of strangulated inguinal hernia treatment, the child remains under observation for a longer period until the surgeon confirms the absence of any potential complications.

Is surgical treatment of inguinal hernia in children painful?

The inguinal hernia surgery itself is completely painless, as it is performed under general anesthesia, so the child does not feel anything during it, but they may experience pain in the surgical area afterward, which can usually be relieved using pain medications prescribed by the surgeon.

What is the recovery period from inguinal hernia surgery in children?

The recovery period from inguinal hernia surgery takes approximately 2-3 weeks, after which the child can return to their daily activities and play with family, or when the surgeon permits.

What is the success rate of laparoscopic inguinal hernia repair surgery?

The success rate of inguinal hernia surgery in children is 90%, and may reach 99% if the parents follow these tips:

• Performing the surgery with a pediatric surgeon with extensive experience in this field.
• Choosing a skilled anesthesiologist.
• Having the child undergo surgery in a hospital equipped with the latest medical equipment.

Learn about: The best pediatric surgeon

What instructions are recommended to follow after inguinal hernia treatment in children?

The surgeon advises the parents, after their child undergoes inguinal hernia surgery, to follow these instructions:

• Administering the prescribed medications regularly.
• Avoiding applying creams to the surgical incision for 7 days post-surgery.
• Avoiding bathing the child for at least 3 days after surgery.
• Preventing the child from engaging in strenuous physical activities.
• Attending the scheduled follow-up appointment with the surgeon to evaluate the surgery’s success.

Learn: The most important tips after inguinal hernia surgery in children

What are the complications of inguinal hernia repair surgery in children?

Laparoscopic inguinal hernia surgery in children is considered a very safe surgical procedure, therefore serious health complications rarely result from it — not exceeding 1% — such as:

• Bleeding
• Infection
• Delayed wound healing.
• An allergic reaction to the anesthesia materials used.
• Formation of blood clots.
• Damage to organs or blood vessels near the hernia site.
• Chronic groin pain resulting from nerve damage during surgery.

When should a pediatric surgeon be consulted after inguinal hernia surgery?

Parents should carefully monitor their child’s condition, especially during the first days following inguinal hernia surgery, and consult the treating surgeon immediately upon the appearance of any of the following symptoms:

• Difficulty urinating.
• Fever exceeding 38°C.
• Severe swelling.
• Redness around the surgical site.
• Severe pain unresponsive to pain medications.
• Vomiting.
• Nausea

Book an appointment for your child now with Dr. Mohamed El-Barbary — who has proven his high competence in surgical treatment of inguinal hernia in children — by calling the numbers listed below on the website.