An otherwise well 8-month-old boy has a reducible left inguinal hernia. His parents ask about repair options. What is the standard operative management at this age?

• A Shouldice multilayered tissue repair
• B Lichtenstein tension-free mesh hernioplasty
• C Laparoscopic TEP repair with preperitoneal mesh
• D Open herniotomy (sac ligation) alone, without mesh ✓

Explanation

In infants and young children the inguinal hernia results from a patent processus vaginalis rather than a muscular-fascial weakness, so high ligation of the sac (herniotomy) alone is curative, with recurrence rates around 1 percent. Mesh repair is reserved for recurrent cases or connective tissue disorders such as Ehlers-Danlos syndrome. Shouldice and adult mesh techniques add nothing because there is no floor deficiency to reinforce. Indian exam convention follows this paediatric principle consistently.

Reference: Pediatric Surgery NaT / Nelson Textbook of Pediatrics, 22nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.