Related Experiment Video
Updated: Apr 19, 2026
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Management of inguinal hernia in premature infants: 10-year experience
Stanley John Crankson1, Khalil Al Tawil2, Mohammad Al Namshan1
1Department of Surgery, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
Insights
Repairing inguinal hernias in premature infants before NICU discharge is safe and avoids incarceration. Delayed repair near term is recommended, and routine contralateral exploration is not justified for inguinal hernia management.
Area of Science:
- Pediatric Surgery
- Neonatology
Background:
- Management of inguinal hernia in premature infants presents challenges.
- Optimal timing for surgical repair remains debated.
Purpose of the Study:
- To review the experience with inguinal hernia management in premature infants.
- To evaluate the safety and outcomes of different repair timings.
Main Methods:
- Retrospective chart review of premature infants with inguinal hernia (1999-2009).
- Group 1: Hernia repair (HR) before neonatal intensive care unit (NICU) discharge.
- Group 2: HR after NICU discharge.
Main Results:
- Eighty-four premature infants were analyzed.
- No incarcerated hernias occurred in Group 1 (n=23).
- Postoperative apnea was not observed in any infant; hernia recurrence and metachronous contralateral hernia rates were 5.9% each.
Conclusions:
- Delaying hernia repair in premature infants until ready for NICU discharge is safe.
- Hernia repair can be performed as day surgery for former premature infants past 47 weeks postconceptional age (PCA).
- Contralateral inguinal exploration is not recommended due to low incidence of metachronous hernias.
Aim:
Debatable issues in the management of inguinal hernia in premature infants remain unresolved. This study reviews our experience in the management of inguinal hernia in premature infants.
Materials And Methods:
Retrospective chart review of premature infants with inguinal hernia from 1999 to 2009. Infants were grouped into 2: Group 1 had repair (HR) just before discharge from the neonatal intensive care unit (NICU) and Group 2 after discharge.
Results:
Eighty four premature infants were identified. None of 23 infants in Group 1 developed incarcerated hernia while waiting for repair. Of the 61 infants in Group 2, 47 (77%) underwent day surgery repair and 14 were admitted for repair. At repair mean postconceptional age (PCA) in Group1 was 39.5 ± 3.05 weeks. Mean PCA in Group 2 was 66.5 ± 42.73 weeks for day surgery infants and 47.03 ± 8.87 weeks for admitted infants. None of the 84 infants had an episode of postoperative apnea. Five (5.9%) infants presented subsequently with metachronous contralateral hernia and the same number of infants had hernia recurrence.
Conclusions:
Delaying HR in premature infants until ready for discharge from the NICU allows for repair closer to term without increasing the risk of incarceration. Because of low occurrence of metachronous hernia contralateral inguinal exploration is not justified. Day surgery HR can be performed in former premature infant if PCA is >47 weeks without increasing postoperative complications.
