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June 1963

Inguinal Hernias in Children: An Operative Diagnosis?

Arch Surg. 1963;86(6):1072-1074. doi:10.1001/archsurg.1963.01310120190027

The philosophy of treatment of inguinal hernias in infants and children has changed remarkably during the past 15 years. Not too long ago, surgical treatment of inguinal hernias in infants was recommended only after incarceration. Surgery was recommended for any asymptomatic hernia only after the child "became older." Today, an infant's hernia is repaired electively, irrespective of age. Complete repair of the inguinal canal was, at one time, the accepted treatment; today, simple ligation of the sac is the treatment of choice. In the past, children were forced to remain in bed postoperatively, and the hospital stay was up to ten days to assure a successful repair. Recently, hospitalization is only 24 to 48 hours.

Along with these progressive changes, some authors advocate contralateral inguinal exploration on all infants below two years of age who have a unilateral hernia. Justification for such bilateral inguinal exploration is founded upon the high