J.Jpn. Surg. Soc.. 81(9): 1206-1207, 1980
Report on the annual meeting
THE OPERATIVE TREATMENT OF INGUINAL HERNIA IN INFANTS AND CHILDREN
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Department of Pediatric Surgery, Kanazawa Medical University Teruho Kajimoto |
Therefore, the operations for adult's hernia are not suitable since different etiology from children.
I have been stressed the philosophy that children's inguieal hernia repair should be safe, easy and non-recurrent method.
In this paper, I would like to mention about few technical points in children's hernia repair.
First, simple herniorrhaphy is best method. (high dissection, transfixed, ligated), that is to say, “surgical removal of the sac without elevating the structures of the cord and without any plastic repair of the muscles or fascia of the inguinal region.” (Potts).
Second, I think that strict high ligation is not necessary. This thought is supported by the evidence from intraperitoneal view that parietal peritoneal lining was flattened even after incomplete “high” ligation.
If the surgeon is borne in mind only about necessity on high ligation, recurrence is not ocurred.
Third, in girls, the ovarian tube is frequently a part of the component of the hernial sac (sliding hernia). In this situation, high ligation is not possible. Pushing the processus by instrument afte ligation just below the tube-attachment, this processus is turned inside out in the peritoneal cavity, good relationship on the location is gained. I have no experience of recurrence by this simple method.
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