Alternative method for repair of the difficult infant hernia

Background: Inguinal hernia repair in the small infant is often technically difficult. An alternative operative approach has been developed that can s implify troublesome repairs, while decreasing the potential risks of damage to cord structures and of recurrence. Methods: Thirteen small infants (weight 1400-3000 grams) underwent inguinal hernia repair using a technique of direct closure of the internal inguinal ring via a trans-hernial sac approach. Dissection of cord structures from the sac was avoided. Results: All hernia repairs remained intact on follow-up of 4-28 months. On e patient early in the series developed a noncommunicating hydrocele, promp ting the addition of sac eversion to the original technique. Conclusions: An alternative method for simplified repair of difficult infan t hernias has been used with success. While it does not supplant traditiona l repair technique for most patients, it should be considered for use in se lected situations. J Pediatr Surg 35:331-333. Copyright (C) 2000 by W.B. Sa unders Company.