Ultrasonography of Inguinal Hernia
Open Inguinal Hernioplasty
Laparoscopic Inguinal Hernioplasty
Inguinal Hernia in Children 兒童腹股溝小腸氣
1.1 About inguinal hernia in children
1.2 Cause of inguinal hernia
1.3 Symptoms of inguinal hernia
- Inguinal hernia in children is an unpredictable condition that cannot be prevented and cannot be detected during pregnancy.
- Parents may notice a protruding lump in the inguinal region of the affected child. The lump tends to become more prominent and larger when the child cries, but it disappears when the child is quiet and at rest, as the organs within the intussusception naturally retract back into the abdominal cavity.
- It is important to note that in inguinal hernia in children, the entrance to the hernia sac can be narrow, which can cause the small intestine within the hernia sac to become trapped. This can lead to a condition called incarcerated hernia. If this condition persists, the blood supply to the small intestine can be compromised, resulting in necrosis of the intestine, known as strangulated hernia, which poses a life-threatening risk to the child.
- Since young children cannot express their pain through verbal communication, they may exhibit restlessness, crying, regurgitation of milk, and older children may complain of abdominal pain.
1.4 Treatment of inguinal hernia in children
Surgical intervention is currently recognized as the only effective method to cure inguinal hernia in children. During the surgery, the doctor will locate and remove the hernia sac, which is considered the most effective surgical approach. In pediatric cases of inguinal hernia repair, there are two methods currently available: conventional (open) surgery and minimally invasive surgery.
1.5 Types of Operation in inguinal hernia repair
Conventional open inguinal hernia repair surgery
- Conventional (open) inguinal hernia repair surgery is performed under general anesthesia. The surgeon will make an incision of approximately two centimeters at the location of the inguinal hernia. Then, they will carefully separate the hernia sac from the spermatic cord and blood vessels and ligate the hernia to prevent the intestine or other abdominal organs from sliding back into the hernia sac. The success rate of the surgery is very high, with a recurrence rate of only about 2-3%. However, there is a 2% chance of damaging the nearby structures such as the vas deferens or blood vessels, leading to testicular atrophy and infertility.
Minimally invasive laparoscopic inguinal hernia repair surgery
- Minimally invasive laparoscopic inguinal hernia repair surgery utilizes advanced minimally invasive techniques to repair inguinal hernias.
- The surgery is performed under general anesthesia. The surgeon will first make a small 2-millimeter incision below the belly button and insert a laparoscope into the abdominal cavity. The laparoscope is a specialized surgical instrument with a camera that displays real-time images of the abdominal cavity on a monitor, allowing the surgeon to have a clear view inside.
- The surgeon will use minimally invasive surgical instruments to locate the hernia, separate it carefully from the spermatic cord and blood vessels, and then tighten and ligate the hernia using a hernia hook. Once the incision is sutured, the surgery is completed, and the procedure takes about 15-20 minutes.
- The benefits of minimally invasive surgery include the ability to use the laparoscope to check for the presence of hernias on the opposite side during the procedure and repair them simultaneously, avoiding the need for additional surgeries.
- The recurrence rate of minimally invasive surgery is very low, at only about 0.1%, and the incisions are small, leaving minimal scarring and significantly reducing the recovery time for patients. Children can engage in activities and return to their daily lives and school as early as the day after surgery.
1.6 Post-operative care
Hospital nursing care
- Due to the use of anesthesia during surgery, children may feel tired, weak, or dizzy after the procedure, but these discomforts will gradually diminish.
- The doctor will prescribe pain medication after surgery, and if necessary, it should be taken as directed by the doctor.
- Since the child has undergone general anesthesia, the nurse will instruct the child to refrain from eating or drinking for 4 hours after surgery.
- After surgery, the child’s wound will be covered with sterile dressings and gauze. Please keep the wound clean and dry.
- Most wounds are closed with absorbable sutures, which will dissolve and be absorbed on their own, so there is no need for suture removal. If suture removal is necessary, it must be done at the designated clinic on the specified day.
- If the wound is covered with waterproof dressings, the child can take a shower as usual the day after surgery. After shower, please ensure that the waterproof dressings remain dry and clean.
- If the surgical site experiences increased pain, redness, swelling, tenderness, oozing of blood, worsening abdominal pain, or fever (with a temperature of 38°C or 100°F or higher), please contact the doctor immediately.
- After surgery, the child can resume eating normally. Please encourage drinking plenty of water and consuming high-fiber foods to prevent constipation.
- For the first 48 hours after surgery, please limit activities to light movements.