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

1. The infant is placed under general anesthesia.
2. A small incision is made in the groin area.
3. The protruding part of the intestine is gently pushed back into the abdomen.
4. The hernia defect is closed with sutures.
5. If a hydrocele is present, it is either drained or removed.
6. 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.