Laparoscopic hernioplasty of inguinal hernia in children

Inguinal hernia in children is a common issue that occurs when a part of the intestine bulges through a weak spot in the abdominal muscles or the inguinal canal. This condition is especially common among newborns and infants but can also occur in older children. Although inguinal hernias do not always cause symptoms, they can lead to significant discomfort and complications if not treated.

Laparoscopic hernioplasty is a minimally invasive surgical procedure that effectively repairs inguinal hernias in children, providing benefits such as reduced pain, shorter recovery time, and minimal scarring. At "Dobrobut" Medical Center, specialists with extensive experience use modern techniques to ensure optimal outcomes for every child.

Causes of Inguinal Hernia in Children

It is difficult to pinpoint exactly what causes inguinal hernias in infants and older children. However, several factors may contribute to their development:

• Congenital features, such as an unclosed inguinal canal, which usually closes before birth, or weakness of the abdominal wall muscles.
• Premature births — premature infants are more likely to develop inguinal hernias due to underdeveloped tissues.
• Increased intra-abdominal pressure related to chronic cough, constipation, or difficulty in urination.
• Genetic predisposition.
• Gender — inguinal hernias are more common in boys than in girls.
• Cystic fibrosis.
• Injuries or excessive straining.
• Poor nutrition, which can lead to muscle and tissue weakness.
• Increased mobility of the child.

It is important to note that having one or more risk factors does not necessarily lead to the development of a hernia. If parents suspect that their child has an inguinal hernia, they should consult a pediatrician or pediatric surgeon for examination and to determine further treatment strategies.

When to See a Doctor

It is crucial to seek medical attention urgently if the child exhibits any of the following symptoms that may indicate an inguinal hernia requiring intervention:

• A noticeable bulge in the groin or scrotal area that becomes more pronounced when the child cries, coughs, or strains.
• Pain, discomfort, and increased sensitivity in the groin area, especially if they worsen during movement or upon touching.
• Increase in the size of the bulge.
• Nausea, vomiting, and other signs of gastrointestinal disturbances.
• Fever.

Indications and Contraindications for Surgery to Remove Inguinal Hernia in Children

Laparoscopic hernioplasty may be indicated under the following circumstances:

• Inguinal hernia causing discomfort and other persistent symptoms, including chronic pain. In this case, scheduled surgical treatment is required.

• Complicated hernia: Emergency surgical intervention is necessary if the hernia is incarcerated and cannot be reduced, or if there is compromised blood supply to the protruding tissue.

Contraindications to laparoscopic hernioplasty may be related to the presence of serious illnesses, clotting disorders, or acute infections.

Diagnosis

To determine the necessity of surgical treatment for inguinal hernia in infants and older children, the pediatric surgeon conducts a physical examination, assessing the condition of the groin area, the presence of bulges, their sensitivity, and the possibility of reduction. The surgeon evaluates the patient's medical history and overall health status, and may order additional tests. Ultrasound or other imaging methods can help determine the size, nature of the hernia, and any potential complications, while blood tests can indicate the body's response to inflammation or infection.

How the Procedure is Conducted

Laparoscopic hernioplasty at "Dobrobut" Medical Center is typically performed as follows:

1. Preparation: Preoperative consultation with the surgeon and anesthesiologist, dietary restrictions on food and drink the day before the procedure.
2. General anesthesia.
3. The surgeon makes several small incisions in the abdominal wall to introduce the laparoscope (a thin tube with a camera) and other microsurgical instruments.
4. Reduction of the hernia: During the operation, the surgeon uses the laparoscope to visualize the hernia, carefully returning the intestine to its place and removing the hernia sac. The site of the defect is then reinforced using mesh or sutures to support the abdominal wall.
5. After successfully removing the hernia, the small incisions are closed with stitches and a sterile dressing.

Recovery

In the recovery period, the child remains under supervision in the pediatric surgery unit. 

Feeding begins with clear fluids, gradually transitioning to regular food depending on the child's condition and recovery speed. It's essential to follow recommendations regarding physical activity restrictions during the first few days post-surgery to avoid stress on the abdominal wall.

Scheduled follow-up visits allow the doctor to assess the healing process, check the condition of the stitches, and address any questions from parents regarding the child's condition and prevention of recurrence.

Complications

Complications following laparoscopic treatment of inguinal hernia in children are relatively rare. Among them are infections, recurrence of the hernia, bleeding, adhesions, and nerve damage that may lead to numbness or chronic pain in the groin area. However, our surgeons follow guidelines for performing hernioplasty, minimizing these risks.

Prevention

To prevent the formation of inguinal hernias and their complications, parents should pay attention to the following aspects:

• Maintaining a healthy weight to reduce strain on the abdominal muscles and help prevent hernia development.
• Teaching children safe lifting techniques for heavy objects.
• Early recognition of symptoms and timely treatment.
• Regular medical check-ups with a pediatrician to monitor the child's health.

Ensuring safety, comfort, and well-being for children is a priority at "Dobrobut" at every stage of treatment. You can schedule a consultation through the form on our website or contact our center by phone.