A 2-year-old boy has a reducible right inguinal hernia confirmed clinically. What is the standard operative management?

• A Laparoscopic TEP repair with mesh
• B Lichtenstein mesh repair
• C Shouldice multilayer repair
• D Open herniotomy with high ligation of the sac alone ✓

Explanation

Paediatric inguinal hernias are almost always indirect, resulting from a patent processus vaginalis, and the posterior wall of the canal is normal. Simple high ligation of the sac at the level of the internal ring, herniotomy, is curative, and mesh reconstruction is unnecessary and undesirable in a growing child. Mesh repairs such as Lichtenstein or TEP are reserved for adults whose recurrence risk stems from tissue weakness rather than a persistent processus vaginalis.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.