Laparoscopic treatment of hernia in children

Oblique inguinal hernia in children is one of the common diseases in children. It is caused by the failure of the processus vaginalis of the peritoneum to close when the testicles descend during the fetal period. The hernia sac is closely related to the spermatic cord, especially at the distal end of the internal ring. A small number of children may heal themselves after conservative treatment before the age of one and a half, but the vast majority of children require surgical treatment. The current academic opinion on the choice of surgical procedure for hernia in children under 14 years old is consistent - high ligation of the hernia sac.

Although the traditional high-position ligation of hernia sac is effective, the surgical incision is relatively long, and the children experience obvious pain after surgery. The most critical and most worrying thing for parents is that the spermatic cord will be severely damaged when the hernia sac is removed! Because the distal end of the hernia sac is very close to the spermatic cord, the spermatic cord of children is very small, and it is easy to injure the spermatic cord during open surgery. In severe cases, it can cause poor blood supply to the testicles or affect fertility. Laparoscopic surgery directly sutures the internal ring opening through the abdominal cavity, without destroying the anatomical structure of the inguinal area, without destroying the cremaster muscle, and without freeing the spermatic cord, thus avoiding damage to blood vessels and nerves, and the interference of the spermatic cord is light, and the operation is simple. During the operation, the contralateral internal ring is also explored. If a hidden hernia is found, it can be directly ligated, which not only avoids the pain of the child's second surgery, but also saves the cost of surgery. Therefore, laparoscopy has unique advantages for bilateral hernia and hidden hernia. The postoperative infection rate of laparoscopic surgery is low, and the incision scar is small and beautiful, which is easily accepted by the majority of parents of children.

At present, our hospital has specially purchased ultra-micro 5mm small-caliber laparoscopic equipment in view of the large number of pediatric patients. Our department has carried out and recommended laparoscopic high ligation of hernia sac for pediatric hernia.