Ultrasound-Guided Pediatric Inguinal Hernia Repair

Abstract

Introduction:

Inguinal hernias are among the most common pediatric surgical operations. For pediatric patients a high ligation of the hernia sac is the most common type of repair, which can be performed open or laparoscopically. Previous studies have shown that the structures of the inguinal canal can be identified with ultrasound. Shown in the video presented here is a technique for performing a high ligation of a hernia sac using ultrasound guidance.

Materials and Surgical Technique:

The technique used here involves the use of a linear 20 MHz ultrasound probe for observation of the inguinal canal and surrounding structures. Physiologic saline is infused into the abdominal cavity to aid in observation of the hernia. Using ultrasound guidance a 0-silk suture is passed around the hernia sac and is tied down to close the hernia. This technique is only used for female patients to avoid injury to the vas deferens or testicular vessels in male patients. If the hernia appears to have contents that cannot be reduced then the operation is converted to a laparoscopic approach to avoid injury to surrounding structures or evaluated for a sliding hernia.

Result and Conclusion:

Ultrasound guidance was used to repair an inguinal hernia in a female pediatric patient. This technique results in a high ligation of the hernia sac, similar to a traditional open or laparoscopic repair. This technique will need to be investigated for durability and may potentially be performed without a general anesthetic in the future.

No competing financial interests exist.

Runtime of video: 4 mins 1 secs