title: A new, simple operative approach for bilateral inguinal hernia repair in girls: A single transverse supra-pubic incision.
abstract: BACKGROUND
  Inguinal hernia repair remains one of the most common operations performed by pediatric surgeons. We described a new surgical approach for treating bilateral inguinal hernias in girls through a small single transverse supra-pubic incision.
  
  
  METHODS
  A new approach was performed on female children 12-years-old and younger with bilateral inguinal hernias between January 2005 and April 2012.
  
  
  METHODS
  A single transverse suprapubic incision (1-1.5 cm) was made. Using sharp and blunt dissection bilateral hernias were exposed and repaired using a standard high ligation.
  
  
  RESULTS
  Ninety-nine girls with a preoperative clinical diagnosis of bilateral inguinal hernia were included. Median age was 2 years (range: 1 month to 12 years). All patients underwent general anesthesia. Median operative time was 12 minutes (range 5-22). There were no intra-operative complications or misdiagnosis. Two patients had bilateral sliding hernias and the remainder had indirect hernias. Post-operatively two patients developed non-expanding small hematomas, both treated non-operatively without sequelae. There were zero hernia recurrence and median follow-up was 5 years (range: 1-8 years) on 99% of patients.
  
  
  CONCLUSIONS
  We described a new, safe, simple, and rapid approach for bilateral inguinal hernia repair in female pediatric population. A single transverse suprapubic skin incision was adequate for exposing both inguinal regions with excellent postoperative results.
authors.affiliation: Divisions of Pediatric Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Abdalla E
authors.initials: AE
authors.lastname: Zarroug
authors.affiliation: European Gaza Hospital, Palestinian Territories, Gaza, Palestine.
authors.forename: Antar M
authors.initials: AM
authors.lastname: Alkhebel
authors.affiliation: General Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Waleed O
authors.initials: WO
authors.lastname: Gibreel
authors.affiliation: European Gaza Hospital, Palestinian Territories, Gaza, Palestine.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Almassry
keywords: Bilateral; bilateral inguinal hernia; females; herniotomy; inguinal hernia; supra-pubic incision