Congenital inguinal hernia repair in pediatric with and without opening the inguinal canal

Abstract

Elective repair of an inguinal hernia, the most common surgery performed by pediatric surgeons, is universally accepted as the treatment of choice. The exact technique and steps involved in the repair differ widely among pediatric surgeons. Many pediatric surgeons open the roof of the inguinal canal while preserving the external ring or by including the ring as described by Ferguson and Gross. This repair is known as a modified Ferguson repair. This technique allows exposure of the internal inguinal ring to ensure high ligation of the sac at that level. In infants, the inguinal canal is so short that the external and internal rings virtually lie over each other, therefore all of the surgery can be done distal to the unopened external ring this technique described by Mitchell–Banks in 1882. In this prospective study, 60 cases of congenital inguinal hernia were randomly selected and divided into two equal groups where is group A underwent the repair with opening the inguinal canal while group B underwent the repair without opening the canal. Conclusively, there are no significant differences between both techniques regarding the intra operative complications and post operative complications in short term follow up; however, modified Ferguson technique appears to consume more time than Mitchell–Banks technique.

Recommendation: Further study on large number of patients with long term follow up is justified to favor one of the two techniques on the other.