Advances in Pediatric Inguinal Hernia and Hydrocele Repair: A Comprehensive Review

Pediatric hernia repair is the most common surgical procedure in children. This review aims to provide an up-to-date overview of pediatric hydroceles and inguinal hernias, encompassing their pathophysiology, presentation, and diagnosis, with a focus on surgical management.

Both open and laparoscopic approaches are safe and effective for pediatric herniorrhaphy. Some studies suggest that laparoscopic repair may be superior, primarily due to its ability to proactively identify and treat a contralateral patent processus vaginalis, thereby preventing metachronous contralateral inguinal hernia. Comparative studies on intracorporeal and extracorporeal methods have yielded mixed results; some show similar recurrence rates, while others indicate higher recurrence with the extracorporeal techniques.

Traditionally, open inguinal herniorrhaphy was the gold standard for hernia repair. However, the shift toward minimally invasive surgery led to increased adoption of laparoscopic techniques. Novel laparoscopic techniques and advanced anesthesia approaches are being performed safely and effectively. These innovations have the potential to transform surgical and anesthesia practices for groin/scrotal surgery. Now that we have utilized laparoscopic herniorrhaphy for more than two decades, there is an opportunity to evaluate the long term outcomes of this approach, providing valuable insights into its sustained benefits and potential areas for improvement