While mesh repair is commonly used in adult hernia surgeries, it's rarely indicated in children. Pediatric inguinal hernias have a different cause and behave differently than adult hernias, which makes their management unique. In this post, we explain why mesh is avoided and what procedure is preferred for kids.
The hernia in children originates from a patent processus vaginalis, an embryological tract that should normally close after birth. It opens into the inguinal canal, allowing abdominal contents to descend, especially in male infants.
In pediatric surgery, the goal is to remove the hernia sac and allow natural closure. The surrounding musculature is strong and healing is efficient. There's no need for reinforcement, unlike in adult hernias.
Clinical Relevance
Mesh is avoided in pediatric hernia repairs due to:
- Interference with growth
- Foreign body risks (infection, migration, chronic pain)
- Very low recurrence rate after simple herniotomy
- Potential harm to testicular structures
Therefore, hernia sac ligation and excision (herniotomy) is the standard treatment in children.