I. What is a pediatric inguinal hernia
Any organ or tissue that leaves its original location and enters another location through a normal or abnormal weak point or defect or orifice of the body is called a hernia. A pediatric inguinal hernia is a protrusion of a pediatric intestinal canal or other organ from the inguinal canal through an unclosed sheath. It is the most common disease in pediatric patients and is more common in males than females, more right than left, and may be bilateral.
What are the effects of pediatric inguinal hernia?
①Repeated return of the hernia mass or long-term compression of the spermatic cord will affect the blood circulation of the spermatic cord and affect the development of the testes;
②The hernia mass increases in size with the course of the disease, making surgery more difficult;
(3) The hernia may become embedded or strangulated, threatening life;
④As the intestinal canal repeatedly enters into the hernia sac, it affects the digestive function of the intestine, and most children have poor digestive function and are thin, which has a certain impact on the growth and development of children.
III. What age is appropriate for children to have surgery
If the hernia attacks frequently and the lump is getting bigger, it is recommended to operate as soon as possible; if the hernia attacks occasionally and the lump is getting smaller, the decision can be made after one year of age.
IV. Availability of non-surgical treatment
Strongly oppose.
①Hernia belt therapy, which is called card, is generally not used. Long-term compression with hernia belt makes local muscle atrophy and adhesion, which makes surgery difficult.
②Injection therapy, which is absolutely undesirable. Blind injection of sclerosing agent can cause serious consequences such as testicular atrophy, cryptorchidism, intestinal adhesions and intestinal necrosis.
V. What is the traditional surgical method
An oblique incision is made in the natural crease of the skin on the pubic bone of the sick child, which is equivalent to the outer edge of the rectus abdominis muscle. This incision needs to be slightly higher and flatter than the adult incision. After incision of the superficial subcutaneous fascia, the tendon membrane of the external oblique abdominal muscle and the external ring, which is proportionally larger than in adults, can be seen. The inguinal canal is short in children, mostly around 1 cm, and the spermatic cord and hernia sac can be revealed by pulling the external ring in an upward direction with a small pulling hook and separating the levator muscle with a hemostat.
Separation of the hernia sac The hernia sac is separated, lifted with hemostatic forceps and then cut open to enlarge the hernia sac incision, and its edges are lifted with hemostatic forceps and spread flat. Between the inner and outer rings, a pair of tissue scissors is reached between the wall of the sac and the spermatic cord, sharply separated around the hernia sac, and the wall of the hernia sac is transected.
The upper part of the hernia sac is bluntly separated from the spermatic cord with gauze to the hernia sac neck.
The neck of the hernia sac is then twisted and sutured, and the excess upper segment of the hernia sac is cut away.
After careful hemostasis, the levator muscle and the tendon membrane of the external oblique abdominal muscle are sutured, and then the subcutaneous tissue and skin are sutured layer by layer.
What are the advantages of minimally invasive surgery?
Minimally invasive surgery is laparoscopic surgery, in which all the above steps are basically omitted, i.e. a 2-5mm incision is made in the umbilicus, a laparoscopic lens is placed, a suture is pierced through the skin, and the inner ring is directly sutured, which has superiority that cannot be compared with traditional surgery.
1.The laparoscope can explore the contralateral side to avoid missing the bilateral hernia;
2.Little trauma, short operation time, quick recovery, little pain and short hospital stay;
3.No damage to the spermatic cord and vas deferens, no postoperative scrotal redness and swelling and strip-like spermatic cord;
4.No scar on the abdomen, good post-operative cosmetic effect, and does not affect future military and other medical examinations;
5, can really high ligation, the chance of recurrence after surgery is small.