Inguinal herniotomy: A national survey

Abstract

Objectives: The objective of this study was to evaluate and describe the current practice of surgical repair of inguinal herniotomy among pediatric surgeons working in Saudi Arabia. Materials and Methods: Between May and June 2018, a questionnaire of 15 multiple choices was sent to all pediatric surgery consultants working in pediatric surgery units across the kingdom of Saudi Arabia. The responses to the questionnaire were analyzed and categorized as shown in the results section. Results: A total of 215 questionnaires were sent, over half of the practitioners fill the questionnaire 56.3% (121). With fair distribution, among type of hospitals were 33% in children hospital, 33% in tertiary hospital, 7% in private hospital, and 8% in general or academic hospitals. Regarding the diagnosis, almost all the surgeons depend on the mother history of a swelling in the groin that comes and goes. The majority (97%) of surgeon will do a standard open herniotomy for male infants, and only 2% will do laparoscopic hernia repair. For ex-premature infants with an inguinal hernia and already discharged from the neonatal intensive care unit, 35% will repair the hernia at presentation regardless of the age, 27% will do it after 50 weeks of postmenstrual age, 18% will do it after 60 weeks of postmenstrual age, 12% will do it after 2 months or above 5 kg weight, and only 8% will do it on urgent basis. Conclusions: The majority of pediatric surgeons depend on a clinical diagnosis of inguinal hernia. Although the timing of surgical repair is still controversial, the majority of pediatric surgeons will repair inguinal hernia as soon as possible. Still, there is no consensus on when or if contralateral inguinal exploration is necessary.