Name of the Procedure:

Repair of Initial Inguinal Hernia, Age 5 Years or Older; Incarcerated or Strangulated

Summary

This procedure involves the surgical repair of an inguinal hernia—where a part of the intestine protrudes through a weak spot in the abdominal muscles—in children aged 5 years or older when the hernia is incarcerated (trapped) or strangulated (blood supply cut off).

Purpose

The procedure aims to:

• Correct the hernia and return the protruding tissue back into the abdomen.
• Repair and reinforce the weakened area of the abdominal wall.
• Prevent complications such as tissue death due to loss of blood supply or bowel obstruction.

Indications

• Persistent pain or swelling in the groin.
• Symptoms of an incarcerated hernia (e.g., severe pain, vomiting, inability to move the bowels).
• Emergency conditions such as strangulated hernia indicated by signs of decreased blood supply to the trapped intestine.

Preparation

• Fast for at least 6-8 hours before surgery.
• Adjust medications as advised by the healthcare provider, especially blood thinners.
• Undergo diagnostic tests such as ultrasound or CT scan to assess the hernia.

Procedure Description

1. Anesthesia: The child is given general anesthesia to ensure they are asleep and pain-free.
2. Incision: A small incision is made in the groin area.
3. Hernia Reduction: The protruding intestine is carefully pushed back into the abdominal cavity.
4. Repair: The weakened area of the abdominal wall is repaired, often using sutures or mesh to reinforce it.
5. Closure: The incision is closed with stitches or surgical glue.

Tools used include surgical scalpels, retractors, sutures, and possibly a surgical mesh.

Duration

The procedure typically takes between 30 minutes to 1 hour.

Setting

Performed in a hospital operating room or an outpatient surgical center.

Personnel

• Pediatric Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma
• Recurrence of the hernia
• Injury to surrounding tissues, including blood vessels and nerves
• Anesthesia-related complications

Benefits

• Relief from pain and discomfort caused by the hernia
• Prevention of severe complications such as strangulation or bowel obstruction
• Improved daily functioning and quality of life

Recovery

• Keep the incision site clean and dry.
• Avoid strenuous activity and heavy lifting for several weeks.
• Pain management with prescribed medications.
• Follow-up appointment for wound check and to ensure proper healing.
• Normal activities can usually be resumed within 1-2 weeks.

Alternatives

• Watchful waiting for non-incarcerated, non-strangulated hernias, although this is generally not recommended for incarcerated or strangulated cases.
• Non-surgical methods like trusses or braces, but these are generally ineffective for incarcerated or strangulated hernias.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Post-surgery, there might be soreness and swelling at the incision site, managed with pain relief medications. Comfort measures include rest and limited activity during recovery.