A 2-year-old boy has a reducible right indirect inguinal hernia. What is the standard definitive surgical management?

• A Laparoscopic TEP repair with preperitoneal mesh
• B Bassini repair with mesh reinforcement
• C Open herniotomy (high ligation of the sac) alone ✓
• D Shouldice four-layer repair without mesh

Explanation

In infants and children the entire pathology is a patent processus vaginalis, and the musculoaponeurotic layers are normal. Simple high ligation of the sac at the level of the deep ring (herniotomy) is curative in well over 95 percent of cases, and mesh or formal floor reconstruction is unnecessary and potentially harmful in growing children. Adult-style repairs such as Bassini, Shouldice or TEP address muscle weakness that does not exist in paediatric hernias.

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.