WOFAPS 2025 8th World Congress of Pediatric Surgery

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Poster - 28

Observational study of adolescent inguinal hernia repairs in a tertiary paediatric surgical department

Sajeed Ali 1, Aadil Ali 2, Sarah Ellul 3, Saravanakumar Paramalingam 1
1 Department of Paediatric Surgery, Royal Alexandra Children’s Hospital, Brighton, UK
2 University College London Medical School, UK
3 Department of Paediatric Surgery and Urology, Southampton Children's Hospital, Southampton, UK

Purpose

The treatment of adolescent inguinal hernia (AIH) has significant variation in surgical approach. This study describes the operative management of AIH in a tertiary paediatric surgical unit.

Method

This is a retrospective study of all AIH repairs in patients aged 10-17 years (defined by WHO) from 2019-2024. Variations in techniques, operative times, outcomes and complications were recorded. SPSS (v30.0) was used for statistical analysis.

Results

33 patients (n=31 male), median age 12.28 years (10.04 –17.04 years) underwent AIH repair (n=22 right, n=2 bilateral) in 5-year period. 3/33 patients had direct inguinal hernia. One patient had a repeat operation for recurrence as adolescent following initial open surgery, totalling 34 operations (n=22 laparoscopic repair).

Mean operative times for open repairs (46.92 mins, SD 29.078) trended greater than laparoscopic repairs (39.55 mins, SD 26.34) (p=0.18). All repairs completed on the pre-operatively planned side, with no incidental contralateral hernia.

9/33 patients underwent preoperative imaging (ultrasound, n=9; MRI, n=1).

2 open hernia repairs were performed emergently for concerns of incarceration, of which one underwent mesh-repair following previous sliding hernia repair.

Laparoscopic repairs demonstrated variability in technique, employing 3/0 Prolene pursestring (n=16), diathermy of internal ring + Ethibond suture (n=5), and bilateral totally extraperitoneal (TEP) repair with mesh (n=1).

Mesh-repairs (n=2) were in conjunction with adult surgeons.

Two recurrences noted (1 following open repair of sliding hernia - recurrence repaired in adolescence, 1 following TEP repair - ongoing review). Two patients have ongoing chronic pain, following mesh-repairs.

Conclusion

These findings demonstrate single-centre multi-surgeon outcomes and procedural variability in AIH repairs, with comparable outcomes but moderate complication rates following mesh repair. Laparoscopic internal ring closure demonstrates good outcomes without recurrence risk in our study.

Keywords: Adolescent inguinal hernia, laparoscopic inguinal hernia repair, general surgery

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