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Inguinal Hernia Repair

What is an inguinal hernia?

When a baby boy is growing in the womb, the testicles first grow in his abdomen.  As the baby develops, the testicles travel down a tunnel into the scrotum.  (In little girls, this tunnel also exists).  Occasionally, this opening (called a processus vaginalis) does not close, leaving an opening from the abdomen into the inguinal canal where a piece of bowel or an ovary can get trapped.

Who gets inguinal hernias?

Inguinal hernias are more common in boys and in premature infants.

How is the decision made that surgery is needed?

You or your primary care provider may have noticed a bulge in the inguinal area (just below the crease in the abdomen). This is bowel or an ovary in the inguinal canal. Once a hernia is noticed, an operation is generally scheduled as soon as possible. This is to prevent the bowel or ovary in the inguinal canal from becoming trapped or incarcerated (strangulated). An incarcerated hernia is an emergency.

What can I expect from surgery?

An incision will be made in the inguinal crease, the bowel or ovary will be replaced in the abdomen and the opening from the abdomen will be closed.  The surgeon may recommend checking the opposite side for a hernia because it is common to have a hernia on both sides. Blood work is not usually necessary and may be needed only if your child has other medical problems.

Bring for your child the day of surgery:

  • A variety of favorite toys, music tapes, or books to encourage quiet time.
  • A special toy or security blanket that may help to comfort your child.
  • Snacks or money to buy yourself a meal.  Please do not eat in front of your child.
  • It is best to make arrangements for siblings to stay at home on the day of surgery in order for you to participate fully in your child’s care.

When will my child be able to go home?

Your child goes to the hospital on the day of surgery and then goes home a few hours after s/he recovers. If your child has a medical condition or is a premature infant an overnight stay may be required for your child’s safety. 

How much time should I plan off work?

Plan on a total of 3-5 days off work including the surgical day.  This will allow for 2 quiet days after the operation.

What care is needed at home after surgery?

  • Care of the incision: There will be an incision in the inguinal skin crease.  Reinforced sticky bandages (Steristrips) may be applied.  A clear plastic dressing or a gauze dressing will cover the incision.  The clear plastic dressing is waterproof.  Remove this dressing according to your surgeon’s instructions. Expect bruising and swelling for at least 3-5 days
  • Activity limitations:
  • 0-8 months: Normal activity for age  
  • 8 months -21/2 years: Be careful of toddler accidents for 2 weeks.
  • 21/2-12 years : Quiet supervised play for 24-48 hours. No running, contact sports, or vigorous activity for 4 weeks.
  • Diet: Your child may have a regular diet, however his/her appetite may not be good for 24-36 hours.  This is normal. Give frequent small amounts of clear liquids (juice, soda, and sugar water).
  • Medication: Give medicine around the clock for the first 24-48 hours and as needed after that for 3-4 days. Please call if your child is uncomfortable. Some children need more medicine than others.
  • Bathing: Keep the diaper area clean and dry. Bathe your child according to the surgeon’s instructions.

Constipation is common after surgery.  Anesthesia and pain medicine can contribute to constipation.  Give your child plenty of clear liquids after surgery.  Call the office if your child goes longer than 48 hours without a bowel movement. 

When should I call the surgery team?

Call if there are any questions or if there is:

  • Bleeding or drainage from the incision
  • Fever above 101 F.
  • Vomiting
  • Less peeing than usual or fewer in wet diapers than usual

When can my child return to daycare or school?

Your child must be closely supervised to avoid accidents for 14 days.  S/he may return to school 48-72 hours after surgery.  S/he should not have physical education classes for 4 weeks. Ask us for a note excusing your child from physical education class.

Long term consequences:

There are few serious long term consequences after hernia repair surgery.  Most children recover quickly without any complications.  The most common complications are infection, recurrence and bleeding.  These complications occur in less than 1% of children.Hernia repair surgery will not affect your child’s growth and development.

 

Please reproduce and distribute this sheet to your surgery families. This teaching sheet can also be downloaded at www.APSNA.org.

Copyright 2006, Mary Ellen Connolly. Copied with permission by Jones and Bartlett Publishers, Sudbury, MA.

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