Single-Center 12-Year Analysis of Inguinal Hernia in Female Children

Abstract

To analyze the clinical presentations of female inguinal hernia and discuss the appropriate surgical approach for hernia repair. A retrospective analysis of female children who received hernia repair for unilateral or bilateral inguinal hernia between 2007 and 2019 was held. A total of 2256 hernia repairs, 1498 (66.3%) open hernia repair (OH), and 758 (33.7%) laparoscopic hernia repair (LH) were performed. There were 1693 (75.0%) unilateral, 889 (39.4%) right, 801 (35.5%) left, 3 (0.1%) unrecorded, and 563 (25.0%) bilateral patients. One hundred seven (14.1%) laparoscopic contralateral explorations led to simultaneous contralateral high ligation. Among LH patients, 3 (0.4%) received repeat LH for ipsilateral recurrent hernia (IRH). Among OH patients, 19 (1.3%) underwent another OH for metachronous contralateral hernia (MCH). There was no significant difference between OH and LH for IRH (P = 0.015), unlike for MCH (P < 0.010). There was a higher percentage of unilateral inguinal hernia than bilateral, with a right-side bias. Despite the associated learning curve, this study advocates for LH as it is a safe procedure that allows for efficient and effective contralateral exploration without increasing total anesthesia time. We also advocate for simultaneous contralateral hernia repair as it would potentially reduce the need for a second surgery and the financial and emotional burden that parents experience with surgery.