Surgery for an inguinal hernia in a child

Operations to remove an inguinal hernia in children in the modern world are practiced quite often. Nevertheless, this is a congenital pathology, accompanied by the exit of organs beyond the abdominal wall, and it can be difficult to cope with it without surgical treatment.

What do parents need to know about inguinal hernia? What are its features in children, how is surgery performed and, most importantly, what are the possible complications?

Features of hernias in children

Cases of inguinal hernia in a child are mostly congenital. In a boy, pathology develops due to a protrusion of the peritoneum in the region of the so-called vaginal process. This is the name of the formation through which the testicles gradually descend into the scrotum. In males, this is often the weakest part of the abdominal wall. If overgrowing does not occur in the process of growing up, then the protrusion can form with age, and not immediately after the birth of the baby.

Inguinal hernia in girls is a rarer occurrence. Its formation is facilitated by the process of lowering the uterus into the small pelvis from the upper part of the abdominal cavity. If the baby's uterus has taken with it part of the connective tissue, then this will lead to the development of pathology.

Inguinal hernia in girls mainly develops if any pathologies of the connective tissue are observed, making it excessively elastic, unstable to negative influences. Small male representatives suffer from its manifestations much more often, which is explained by a longer inguinal canal, which is less resistant to various stresses.

What you need to know about the disease

If the doctor has diagnosed an inguinal hernia in a baby of any gender, he should inform the parents about its following features:

• pathology is dangerous, since there is always a risk of infringement with subsequent necrosis of tissues that have fallen into the bag;
• in the fair sex, the disease, if not treated in a timely manner, leads to problems with the reproductive system more often than in boys;
• at the first symptoms indicating infringement, the child should be taken to the hospital;
  with the development of an inguinal hernia in a child, surgery can be avoided only in exceptional cases;
• the choice of the operating doctor should be taken as carefully as possible, since the intervention should be carried out only by a specialist with extensive experience;
• so that everything goes well, it is better to plan the intervention in advance, and not wait for infringement or other complications;
• if the baby is operated on urgently, the risk of relapses and complications increases, as doctors do not have time to plan the course of the intervention.

Inguinal hernia is a dangerous disease that must be taken with the utmost seriousness. It is better to consult with doctors when its symptoms appear and carry out the operation as early as possible, without delay.

When to do and when not to have surgery

The presence of an inguinal hernia in a child, even if its formation is not accompanied by complications, is the main indication for surgical intervention. It does not matter whether there are symptoms of acute problems, or they are absent. The only difference is that in the presence of acute symptoms, surgery is performed urgently, and in their absence, the manipulation is carefully planned by physicians.

There are a number of cases when it is forbidden to operate on a baby. Indications can be either relative or absolute. Relative indications are acute diseases (colds, flu, etc.), accompanied by an active inflammatory process, as well as some other pathologies that can be stopped. As soon as these contraindications are eliminated, the intervention will be allowed.

Everything is more complicated with absolute contraindications.

These include:

• various pathologies of the blood;
• diseases of the cardiovascular system;
• a serious imbalance in the functioning of the kidneys or liver;
• feverish state;
• various disorders of the neurological spectrum.

If the child cannot be operated on due to the presence of absolute contraindications, conservative treatment will have to be performed.

Techniques

Today, only modern, low-traumatic technologies are used to perform an operation for inguinal hernia in children, the task of which is to eliminate symptoms as efficiently as possible and prevent relapses. In most cases, the operation takes no more than an hour and is well tolerated by babies, although, of course, there are exceptions.

Before you get to the surgeon, the child undergoes a thorough medical examination. Consultations of a neuropathologist, a cardiologist are considered mandatory. Urine and blood tests are taken, X-rays are taken.

Pediatric surgery today uses two main methods of surgical intervention. At the same time, access to the operated hernia is obtained in different ways.

public method

The open method of surgical intervention is older and more complex. It is used to remove a hernia if its size is very large or there are any serious complications.

The operation usually consists of several stages:

• the surgeon performs a layer-by-layer dissection of tissues in order to exclude their severe damage;
• the hernial sac is detected and carefully opened, the condition of the organs and tissues in it is assessed;
• if there are no serious injuries to the internal organs, then they are reduced into the abdominal cavity;
• if there is damage, then part of the organ is removed within healthy tissues;
• the hernial sac and the area of ​​pathology are sutured by tightening the patient's own tissues or, alternatively, by applying a special restraining mesh;
• the postoperative wound is sutured and treated.

The open method of surgery is rarely used today. It has been successfully replaced by laparoscopy.

Laparoscopy

Laparoscopy is the preferred option for getting rid of hernia in the groin area in the modern world. The operation is performed through a tiny incision. In this case, the course is controlled using a special camera, which is inserted into the wound through a tube, like all instruments for performing manipulations.

Basically, laparoscopy requires no more than half an hour, but sometimes it can be delayed. A significant advantage of this approach is the shortest rehabilitation period, as well as the almost complete absence of scars. The only disadvantage of the technique is that it cannot be used if the hernia is too large.

Possible Complications

Any complications after the planned surgical treatment is carried out are very rare. At the site of surgery, small hematomas or unexpressed bleeding may be noted, but they stop without special treatment on the first day.

During emergency operations, the following undesirable consequences are possible:

• severe pain after the cessation of anesthesia;
• swelling of the scrotum;
• hematomas in the testicles or scrotum in boys;
• infection of the postoperative wound;
• suppuration of the scar itself in the process of its healing.

As a possible complication, the recurrence of the pathology cannot be excluded. It develops most often if the hernial sac was initially large. Also, relapses are often found in children who were born severely premature or have gross malformations.

Among the undesirable consequences also appear the divergence of the seams, damage to the intestinal wall or bladder. When sewing the spermatic cord in boys, infertility is possible. In girls, due to the intervention, displacement of the ovary is possible, which also leads to infertility. These undesirable consequences are most often a consequence of the wrong action of the surgeon or his lack of experience.

To avoid such problems, it is recommended to deal with hernia treatment in a timely manner, and not on an emergency basis.

Features of the rehabilitation period

Removing an inguinal hernia in children is usually easy, and the rehabilitation period does not require any special efforts.

All that is required of parents is to follow a number of simple rules:

• the diet prescribed by the doctor is observed, excluding foods that lead to constipation, diarrhea, excessive gas formation;
• physical activity is excluded, including coughing, sneezing, strong and long cries of the baby;
• it is necessary to carefully monitor the cleanliness of the postoperative wound and the dressings of the child in order to prevent infection;
• if any complications develop, it is recommended to immediately consult a doctor.

If parents carefully follow all the recommendations received from the doctor, the healing of the postoperative wound passes quickly, without causing any harm to the child. After such rehabilitation, the baby will not remember that he once suffered from a hernia.