When it becomes necessary to perform herniorrhaphy on one side in young children it is also necessary to consider the advisability of exploring the other side for incipient hernia. A group of 100 children under 2 years of age underwent operation because of unilateral complaints without signs or symptoms of contralateral hernia; nevertheless exploration revealed evidence of contralateral hernia in 61 of these. A second group of 237 underwent unilateral herniorrhaphy without surgical exploration of the contralateral side; 73 of these were found later, in a follow-up study, to have undergone subsequent contralateral herniorrhaphy at various times up to nine years after the first operation. The disadvantages of operating twice are considerable. The authors recommend, instead, that all herniorrhaphies undertaken on children less than 2 years old be bilateral.
Kiesewetter WB, Parenzan L. WHEN SHOULD HERNIA IN THE INFANT BE TREATED BILATERALLY? JAMA. 1959;171(3):287–290. doi:10.1001/jama.1959.03010210039011
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