What is the standard definitive operation for a congenital indirect inguinal hernia in a healthy term infant?
- A Herniotomy plus Lichtenstein mesh reinforcement
- B Herniotomy alone, that is high ligation of the patent processus vaginalis ✓
- C Shouldice repair of the posterior wall
- D Herniotomy followed by routine contralateral open exploration
Correct answer: B. Herniotomy alone, that is high ligation of the patent processus vaginalis
Explanation
In children the hernia results solely from a patent processus vaginalis, and the musculature of the canal is normal, so simple high ligation of the sac cures the condition. Mesh repair is unnecessary and undesirable in growing tissue. Routine contralateral exploration is no longer recommended given low metachronous rates and laparoscopy if concern exists. Repair of the posterior wall addresses a defect that simply does not exist in paediatric patients.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.