Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible
CPT4 code
Name of the Procedure:
Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible.
Summary
This procedure involves the repair of an inguinal hernia, a condition where a part of the intestine protrudes through the abdominal wall or inguinal canal in preterm infants. It can be performed with or without the removal of a hydrocele, a fluid-filled sac surrounding a testicle.
Purpose
The procedure addresses an inguinal hernia and possibly a hydrocele in preterm infants. The goal is to prevent complications such as bowel obstruction or incarceration and to ensure normal growth and development.
Indications
- Noticeable bulge in the groin or scrotum area.
- Symptoms of discomfort or pain in the groin.
- Preterm infants born before 37 weeks of gestation.
- Hernia that appears reducible upon examination.
Preparation
- Fasting for a few hours prior to the procedure.
- Physical examination and medical history review.
- Pre-operative blood tests and imaging studies such as an ultrasound.
Procedure Description
- The infant is placed under general anesthesia.
- A small incision is made in the groin area.
- The protruding part of the intestine is gently pushed back into the abdomen.
- The hernia defect is closed with sutures.
- If a hydrocele is present, it is either drained or removed.
- The incision is closed with dissolvable stitches or surgical glue.
Duration
The procedure typically takes about 30 to 45 minutes.
Setting
The procedure is usually performed in a hospital's operating room.
Personnel
- Pediatric surgeon
- Anesthesiologist
- Surgical nurses
- Pediatric care team
Risks and Complications
- Infection at the incision site.
- Bleeding.
- Recurrence of the hernia.
- Injury to surrounding tissues or organs.
- Anesthesia-related risks.
Benefits
- Relief from pain and discomfort.
- Prevention of bowel obstruction or incarceration.
- Improved quality of life.
- Normal growth and development.
Recovery
- Monitoring in the recovery room until anesthesia wears off.
- Pain management with medications.
- Instructions on caring for the incision site.
- Follow-up appointment with the surgeon.
- Most infants recover within 1 to 2 weeks with minimal activity restrictions.
Alternatives
- Watchful waiting for minor asymptomatic cases.
- Non-surgical treatments are generally not effective for reducible inguinal hernias in infants.
- The surgical approach is typically the recommended and effective solution.
Patient Experience
- The infant will be under general anesthesia and will not feel pain during the procedure.
- Post-operative discomfort can be managed with pain medications.
- Parents should expect some fussiness or discomfort in the first 24-48 hours post-surgery.
- Frequent monitoring and comfort measures will be provided by the care team.