WOFAPS 2025 8th World Congress of Pediatric Surgery

Selay Tay ¹, Ali Ekber Hakalmaz ¹, Ali Sezer ¹, Beste Girgin ¹, Ayşe Kalyoncu Uçar ², Rahşan Özcan ¹, Gonca Topuzlu Tekant ¹

¹ Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine, Department of Pediatric Surgery
² İstanbul University-Cerrahpasa, Cerrahpaşa Faculty of Medicine, Department of Radiology, Division of Pediatric Radiology

Purpose:

To evaluate the long-term outcomes of patients in adolescence who underwent high ligation (HL) surgery for indirect inguinal hernia.

Methods:

A retrospective review was conducted on patients aged 12–18 years at the time of surgery and underwent HL for indirect inguinal hernia between 2012 and 2022. Clinical and radiological data before and after the operation, as well as intraoperative findings, were analyzed.

Exclusion criteria included missing data, direct hernia, prepubertal status, presence of connective tissue disease or undescended testis, and repairs performed using different surgical techniques.

Results:

A total of 22 patients were included in the study. All patients presented with swelling and pain preoperatively. The mean age at surgery was 13.90 years (range: 12–17 years). The male-to-female ratio was 2.66 (16 males, 6 females). HL was performed on the right side in 13 patients, on the left in 7, and bilaterally in 2 patients. The Ferguson maneuver was carried out in all repairs. During long-term follow-up, three patients developed unilateral neuropathic pain. No recurrences of indirect or direct hernia were observed. In two male patients, a pre-existing testicular size discrepancy of less than 10% persisted postoperatively. The mean follow-up duration was 7.41 years (range: 3–13 years).

Conclusion:

High ligation is an effective and safe surgical technique that can be reliably used in the treatment of adolescent indirect inguinal hernias.