One stitch abdominal closure herniotomy: An alternative to Laparoscopic hernia repair in infants

The hernias need to be addressed at an earlier stage to prevent the development of complications mainly strangulation. The risk of complications is more in children <6 months of age. About 90% of complications can be prevented if a hernia repair is performed within a month of diagnosis [1,2]. Almost all hernias in children are indirect type, where the gut or the omentum enters the preformed sac (patent processus vaginalis) deep inguinal ring and traverses the inguinal canal to reach the superficial ring. In the newborn, the length of inguinal canal is negligible. The rings are superimposed over each other and the hernia is anatomically lateral to the inferior epigastria vessels. Herniotomy is considered sufficient in infants and no repair or reinforcement of the inguinal canal is required. Traditionally, the method of herniotomy involves “the spermatic cord outside the superficial inguinal ring” approach. A skin crease incision about 2 to 3 cm long is made above the pubic tubercle. The incision is advanced, the inguinal canal is approached, and the procedure is completed. We present a series of cases where an incision 1 cm is made to approach the inguinal canal, herniotomy performed, and the incision closed with a single U-stitch.