Pediatric Inguinal Hernia Repair

Editor(s): Nestor R. Villamizar, MD Nestor R. Villamizar, MD

Department of Surgery
Duke University Medical Center
Durham, NC | Theodore N. Pappas, MD Theodore N. Pappas, MD

Department of Surgery
Duke University Medical Center
Durham, NC | Henry E. Rice, MD Henry E. Rice, MD

Department of Surgery
Duke University Medical Center
Durham, NC

INDICATIONS

CONTRAINDICATIONS

Weight less than 2 to 3 kg, unless there is a history of incarceration (relative contraindication)

EQUIPMENT

ANATOMY

External (superficial) ring: The ovoid opening of the external oblique aponeurosis is located superior and slightly lateral to the pubic tubercle. The spermatic cord exits the inguinal canal through the external inguinal ring.
Internal (deep) ring: The superior crus is the transversus abdominis aponeurotic arch, which is formed by fibers of the lower margin of the transversus abdominis and internal oblique muscles. The inferior crus is the iliopubic tract.
Important nerves

Sample excerpt does not include step-by-step text instructions for performing this procedure

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CARE

COMPLICATIONS

RESULT ANALYSIS

After the diagnosis of a reducible hernia is made, repair should be performed soon to avoid incarceration.
An incarcerated inguinal hernia must be emergently reduced, either manually or surgically. To minimize the risk for recurrence, definitive hernia repair should be performed within 5 days (within 2 days for infants born prematurely) of the manual reduction.