Treatment of intestinal hernia in boys

In life, many little boys suffer from hernia. Its basic symptom is the appearance of a reducible mass in the groin area. The mass is small at first and only appears when standing, working, walking, running, coughing violently or crying, which has a great impact on the child's life and study. Next, I will introduce to you the treatment method for boys' intestinal hernia.

Surgical treatment: Indirect hernia cannot heal on its own and may become incarcerated or strangulated, so it should be treated surgically. However, for children under one year old, the abdominal wall becomes stronger as it grows and develops, and it is possible to heal on its own, so surgery can be postponed. Surgery is not suitable for the elderly and weak who suffer from other serious diseases. After the hernia mass is reduced, a hernia support can be used to compress the hernia ring tightly, which can be removed during rest at night. Long-term use of a hernia splint may cause adhesion of the hernia contents to the neck of the hernia sac and is generally not recommended.

The surgical principle for indirect hernia is high ligation of the hernia sac and hernia repair. For children, only high ligation of the hernia sac is performed to avoid affecting the development of the spermatic cord and testicles and destroying the physiological closure mechanism of the inguinal canal. Hernioplasty is rarely performed unless there is a large defect in the abdominal wall. High ligation of hernia sac: In order to eliminate the residual processus vaginalis of peritoneum, it is necessary to transect the hernia sac and then peel off its proximal end to the inner ring, where the extraperitoneal fat layer can be seen, and its deep surface is the parietal peritoneum. The hernia sac neck is ligated high with silk thread at this plane. The distal hernia sac generally does not need to be removed and the sac opening is left open.

Hernia repair: As indirect hernia develops, the internal ring is gradually expanded and the strength of the peritoneum is further weakened. Therefore, hernia repair must be performed after high ligation of the hernia sac. Hernia repair should include two concepts: repairing the enlarged internal ring and repairing the weak parts of the inguinal canal. Before repairing the inguinal canal, the enlarged internal ring must be explored and repaired, otherwise recurrence will be inevitable. To this end, after the hernia sac is ligated high and hard, the levator testis muscle must be further dissected and cut at the root to better expose the enlarged internal ring and interconcave ligaments. The interconcave ligaments are sutured to shrink the internal ring to the extent that it can only accommodate the spermatic cord to pass through. The main surgical methods for repairing weak parts of the inguinal canal are as follows:

1. Ferguson method (Figure 1) Suture the lower edge of the internal oblique muscle, the transverse abdominal aponeurosis arch and the conjoint tendon to the inguinal ligament superficial to the spermatic cord to strengthen the anterior wall of the inguinal canal. It is suitable for smaller indirect hernias and those with a healthy posterior wall of the inguinal canal.

(1) The spermatic cord remains in its original position and the levator testis muscle is sutured.

(2) Suture the lower edge of the internal oblique muscle, the transverse abdominal aponeurosis arch, and the conjoint tendon to the inguinal ligament

(3) Overlap suture of the external oblique aponeurosis

2. Bassini method: the spermatic cord is lifted free, and the lower edge of the internal oblique muscle, the transverse abdominal aponeurosis arch and the conjoint tendon are sutured to the inguinal ligament on its deep surface to strengthen the posterior wall of the inguinal canal. The spermatic cord is shifted between the internal oblique muscle and the external oblique aponeurosis. It is suitable for larger indirect hernias and those with weakened posterior wall of the inguinal canal. To judge the strength of the posterior wall of the inguinal canal, the transverse abdominal aponeurosis and the transverse abdominal fascia, during the operation, you can insert your fingers into the inner ring and push the abdominal wall on the inside toward the body surface to feel its strength. This procedure is currently more commonly used.

The above introduces the treatment methods for boys' hernia. In daily life, we should pay attention to a reasonable and healthy diet and lifestyle, and it is also very important to maintain a positive attitude. Hopefully, these methods will be effective for patients. These are just textual explanations. If you have any questions, be sure to seek medical attention immediately.