Surgical treatment of inguinal hernia in neonates and infants: Early surgery or elective surgery?

PURPOSE: The surgical technique for inguinal hernia repair is well established. However, the safety of this procedure in young children still remains under debate because of risks of general anesthesia in young children. We assessed the indications for inguinal hernia repair in neonates and infants. PATIENTS AND METHODS: Between 2007 and 2017, laparoscopic hernia repair was performed in 408 patients at our institution. We reviewed the data from their medical records, including their sex, age at surgery, and incidence of asymptomatic patent processus vaginalis (PPV) during the surgery. RESULTS: The incidence of asymptomatic contralateral PPV in the female neonates/infants in whom the original hernia was on the left side was 75% and higher as compared to the frequency in other subpopulations. The incidence of bilateral inguinal hernia repair in female neonates/infants was 68.8% and higher as compared to that in other subpopulations. CONCLUSION: The incidence of an asymptomatic contralateral PPV and of a bilateral inguinal hernia repair was higher in female neonates/infants as compared to the corresponding frequencies in other subpopulations. In some infants of this group, the PPV on the contralateral side could potentially close as the children grew older. Therefore, girls with inguinal hernia under 1 year of age should be treated by elective surgery after they become at least 1 year old.