title: Alternative method for repair of the difficult infant hernia.
abstract: BACKGROUND
  Inguinal hernia repair in the small infant is often technically difficult. An alternative operative approach has been developed that can simplify troublesome repairs, while decreasing the potential risks of damage to cord structures and of recurrence.
  
  
  METHODS
  Thirteen small infants (weight 1400-3000 grams) underwent inguinal hernia repair using a technique of direct closure of the internal inguinal ring via a trans-hernial sac approach. Dissection of cord structures from the sac was avoided.
  
  
  RESULTS
  All hernia repairs remained intact on follow-up of 4-28 months. One patient early in the series developed a noncommunicating hydrocele, prompting the addition of sac eversion to the original technique.
  
  
  CONCLUSIONS
  An alternative method for simplified repair of difficult infant hernias has been used with success. While it does not supplant traditional repair technique for most patients, it should be considered for use in selected situations.
authors.affiliation: Department of Pediatric Surgery, Kaiser Permanente Medical Center, Los Angeles, CA 90027, USA.
authors.forename: H
authors.initials: H
authors.lastname: Applebaum
authors.forename: N
authors.initials: N
authors.lastname: Bautista
authors.forename: J
authors.initials: J
authors.lastname: Cymerman
mesh_terms: D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011126:Polypropylenes; D013537:Sutures
chemical_list: D011126:Polypropylenes