A Novel Operating Approach for Inguinal Hernia in Girls

Dr Manoj Kumar Mohanty; Dr Santosh Kumar Mahalik; Dr Bikasha Bihary Tripathy; Dr Akash Bihari Pati

Volume : VII, Issue : II, February - 2018

A Novel Operating Approach for Inguinal Hernia in Girls

Dr Manoj Kumar Mohanty, Dr Santosh Kumar Mahalik, Dr Bikasha Bihary Tripathy, Dr Akash Bihari Pati

Abstract :

Background: Inguinal hernia repair is one of the most commonly performed surgeries in children. The standard operating procedure is an open inguinal herniotomy from inguinal skin crease incision. In this study, we have described a novel operating approach for inguinal hernia repair in girls which is based on emyology and anatomy of female pelvis. In this technique, we approach the hernia sac from a much lower down incision on mons pubis adjacent to the labia majora on the affected side.

Materials & method: It is a retrospective analytical study on girls with inguinal hernia who underwent open herniotomy with this novel approach between January 2004 to December 2016.

Technique: A small transverse incision was given over mons pubis just above and lateral to the labia majora on the affected side. Hernial sac is dissected along the round ligament of uterus, sac opened, contents reduced to the peritoneal cavity and the sac is transfixed at the level of deep inguinal ring (as in open inguinal herniotomy)

Results: Seventy–five girls with inguinal hernia were included in the study. Forty girls had right sided inguinal hernia, 26 had left side hernia and 9 had bilateral inguinal hernia. The hernia sac was empty in 49 cases, ovary and fallopian tube in 15 cases, omentum in 4 cases, ovary& fallopian tube as sliding component in 7 cases. Only two patients developed a minor wound infection and none developed any hematoma, wound dehiscence, chronic pain or paraesthesia and recurrence of hernia. Median operating time was 15 min and it was cosmetically better as the scar is well hidden.

Conclusion: We described a novel operating technique for inguinal hernia in girls which is quick, safe, cosmetically better and anatomically less damaging to the inguinal canal than conventional inguinal hernia surgery.