Our Summary

This research paper looks at how two different types of surgery are used to treat children with inguinal hernias (where tissue pushes through a weak spot in the groin muscle).

The two types of surgery compared were ‘high ligation’, where the hernia sac is removed and the area is sealed off, and ‘iliopubic tract repair’, which includes stitching up a couple more parts of the groin area.

The team looked at over 3,000 children under 10 who had these surgeries between 2016 and 2018. They found that hernias came back in less than 1% of the children who had the ‘high ligation’ surgery, but in none of the children who had the ‘iliopubic tract repair’.

Other outcomes and complications were pretty much the same for both groups. The study concluded that the ‘iliopubic tract repair’ surgery has a slightly lower risk of the hernia coming back.

FAQs

  1. What are the two types of surgery used to treat children with inguinal hernias mentioned in the research paper?
  2. According to the research, which surgery type has a lower risk of the hernia coming back?
  3. How many children under 10 who had these surgeries were studied in the research?

Doctor’s Tip

A doctor might tell a patient that both high ligation and iliopubic tract repair are effective options for pediatric hernia repair, but the latter may have a slightly lower risk of the hernia returning. It’s important for the patient to follow post-operative care instructions and attend follow-up appointments to ensure proper healing and monitor for any complications.

Suitable For

Overall, pediatric patients who are recommended for hernia repair surgery are typically those who have been diagnosed with an inguinal hernia. Inguinal hernias are common in infants and young children, with boys being more likely to develop them than girls.

Children with inguinal hernias may experience symptoms such as a bulge in the groin area, pain or discomfort, and swelling. In some cases, the hernia may become incarcerated or strangulated, which can lead to serious complications and require emergency surgery.

Surgery is usually recommended for pediatric patients with inguinal hernias to prevent complications and alleviate symptoms. The decision to undergo surgery and the choice of surgical technique may depend on factors such as the age of the child, the size and type of hernia, and the presence of any other medical conditions.

In general, pediatric hernia repair is considered a safe and effective procedure with a low risk of complications. The choice of surgical technique, such as high ligation or iliopubic tract repair, may be based on the surgeon’s preference and experience, as well as the specific characteristics of the hernia in each individual patient.

Overall, pediatric patients who are recommended for hernia repair surgery are those who have been diagnosed with an inguinal hernia and are experiencing symptoms or are at risk of complications. Surgery is typically safe and effective in this population, with the choice of surgical technique based on individual factors and surgeon preference.

Timeline

Before pediatric hernia repair:

  • The patient may experience symptoms such as a visible bulge in the groin area, pain or discomfort in the groin, and nausea or vomiting.
  • The patient may undergo physical examination and imaging tests to confirm the presence of a hernia.
  • The patient may be advised to avoid strenuous activities or lifting heavy objects to prevent worsening of the hernia.

After pediatric hernia repair:

  • The patient will undergo surgery to repair the hernia, either through ‘high ligation’ or ‘iliopubic tract repair’.
  • The patient may experience pain, swelling, and bruising in the surgical area immediately after the procedure.
  • The patient will be monitored for any complications such as infection or recurrence of the hernia.
  • The patient will be advised on post-operative care, including restrictions on physical activities and follow-up appointments with the healthcare provider.
  • The patient may experience a full recovery within a few weeks to months, depending on the type of surgery and individual healing process.

What to Ask Your Doctor

  1. What are the risks and benefits of each type of surgery (high ligation vs. iliopubic tract repair) for pediatric hernia repair?
  2. How long is the recovery period for each type of surgery?
  3. Are there any long-term effects or complications associated with either type of surgery?
  4. What is the success rate of each type of surgery in preventing the hernia from coming back?
  5. Are there any specific factors that would make one type of surgery more suitable for my child than the other?
  6. How experienced are you in performing pediatric hernia repairs, specifically the type of surgery you are recommending?
  7. Are there any alternative treatment options for pediatric hernias that we should consider?
  8. What can we expect in terms of pain management and post-operative care for my child after the surgery?
  9. How often will my child need follow-up appointments after the surgery?
  10. Are there any lifestyle changes or restrictions my child will need to follow after the surgery to prevent the hernia from recurring?

Reference

Authors: Lee SR, Park PJ. Journal: Surg Endosc. 2021 Jan;35(1):216-222. doi: 10.1007/s00464-020-07382-1. Epub 2020 Jan 14. PMID: 31938927