A 2-year-old boy has a reducible right inguinoscrotal swelling that appears on crying. Examination confirms an indirect inguinal hernia. What is the standard operative management?
- A Lichtenstein tension-free mesh repair
- B Open herniotomy with high ligation of the sac alone, without mesh ✓
- C Laparoscopic TEP repair with mesh
- D McVay repair with a relaxing incision
Correct answer: B. Open herniotomy with high ligation of the sac alone, without mesh
Explanation
In children an indirect inguinal hernia results from a patent processus vaginalis rather than a musculoaponeurotic weakness, so simple high ligation of the sac at the deep ring (herniotomy) is curative and mesh is unnecessary. Mesh repairs address adult floor weakness and carry theoretical and practical disadvantages in growing children. Laparoscopy is reserved for selected cases such as bilateral or recurrent paediatric hernias, and McVay repair addresses femoral and adult defects irrelevant here.
Reference: Pediatric Surgery NaT / 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.