UNC's Groin Hernia Repair in Children is Fast, Safe ...and Essential

Apr 17, 2001, 01:00 ET from UNC Health Care

    CHAPEL HILL, N.C., April 17 /PRNewswire/ -- In the womb, everyone has a
 hole in the muscles on each side of the groin.  This hole -- called the
 internal ring -- closes around the time of birth in most people.  The 2 to 5
 percent of children whose internal rings don't close normally are at high risk
 for groin hernias.
     In children of both sexes, the intestines can protrude through the
 internal ring, and girls can have their ovaries slip through the opening.
 These hernias can occur within the first few days of life, or they may not
 appear for 10 or 15 years.  Regardless of when they occur, groin hernias
 should be repaired to prevent serious problems.
     "If part of the intestine bulges through the opening and gets stuck, it
 can rupture," said Dr. Duncan Phillips, a pediatric surgeon at N.C. Children's
 Hospital.  "There is a risk of serious infection, and you can lose part of the
 intestine.  Girls can lose blood supply to an ovary that becomes stuck."
     Groin hernia surgery is usually done as an outpatient procedure.  It only
 takes about an hour, and the rate of complications is very low.  The surgeon
 gently pushes the protruding organs back into the abdominal cavity and closes
 the internal ring.  Most children who have this surgery are able to resume
 their normal activities within two or three days.
     Only 7 to 15 percent of children who have a hernia on one side of their
 groin will later have a hernia on the other side.  But most parents want to
 know for sure if their child is at risk.
     In the past, checking the second internal ring meant the surgeon had to
 make another incision, on the other side of the groin.  In 85 to 93 percent of
 cases, this turned out to be unnecessary.  Now, pediatric surgeons can avoid
 making needless incisions by using a laparoscope.  This is a long, thin
 optical tube connected to a video camera that allows surgeons to view internal
 organs.
     "While we are repairing the hernia on one side, we can insert a special
 laparoscope through the incision and look around the corner," Phillips
 explained.  "We can examine the other side of the groin from the inside and
 see if there is the potential for a hernia there.  If we don't find a problem
 we just pull the scope out.  If we do find a problem, then we fix it, too."
 Phillips said the diagnostic laparoscopy only takes six minutes and has a 99
 percent accuracy rate.
     The rate of recurrence of groin hernias in children is only about one
 percent, compared to a recurrence rate of 10 percent in adults.
     "Adult groin hernias are often due to weakness in the muscle, and
 straining the muscle can cause a new hernia," Phillips said.  "In children,
 the cause is different.  It's a congenital condition, and once it's fixed, it
 stays fixed."
 
 

SOURCE UNC Health Care
    CHAPEL HILL, N.C., April 17 /PRNewswire/ -- In the womb, everyone has a
 hole in the muscles on each side of the groin.  This hole -- called the
 internal ring -- closes around the time of birth in most people.  The 2 to 5
 percent of children whose internal rings don't close normally are at high risk
 for groin hernias.
     In children of both sexes, the intestines can protrude through the
 internal ring, and girls can have their ovaries slip through the opening.
 These hernias can occur within the first few days of life, or they may not
 appear for 10 or 15 years.  Regardless of when they occur, groin hernias
 should be repaired to prevent serious problems.
     "If part of the intestine bulges through the opening and gets stuck, it
 can rupture," said Dr. Duncan Phillips, a pediatric surgeon at N.C. Children's
 Hospital.  "There is a risk of serious infection, and you can lose part of the
 intestine.  Girls can lose blood supply to an ovary that becomes stuck."
     Groin hernia surgery is usually done as an outpatient procedure.  It only
 takes about an hour, and the rate of complications is very low.  The surgeon
 gently pushes the protruding organs back into the abdominal cavity and closes
 the internal ring.  Most children who have this surgery are able to resume
 their normal activities within two or three days.
     Only 7 to 15 percent of children who have a hernia on one side of their
 groin will later have a hernia on the other side.  But most parents want to
 know for sure if their child is at risk.
     In the past, checking the second internal ring meant the surgeon had to
 make another incision, on the other side of the groin.  In 85 to 93 percent of
 cases, this turned out to be unnecessary.  Now, pediatric surgeons can avoid
 making needless incisions by using a laparoscope.  This is a long, thin
 optical tube connected to a video camera that allows surgeons to view internal
 organs.
     "While we are repairing the hernia on one side, we can insert a special
 laparoscope through the incision and look around the corner," Phillips
 explained.  "We can examine the other side of the groin from the inside and
 see if there is the potential for a hernia there.  If we don't find a problem
 we just pull the scope out.  If we do find a problem, then we fix it, too."
 Phillips said the diagnostic laparoscopy only takes six minutes and has a 99
 percent accuracy rate.
     The rate of recurrence of groin hernias in children is only about one
 percent, compared to a recurrence rate of 10 percent in adults.
     "Adult groin hernias are often due to weakness in the muscle, and
 straining the muscle can cause a new hernia," Phillips said.  "In children,
 the cause is different.  It's a congenital condition, and once it's fixed, it
 stays fixed."
 
 SOURCE  UNC Health Care