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At UPMC Children's Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this surgery and invite you to participate. Please read the following information to learn about the surgery and how you can help.
An inguinal (IN-gwa-nul) hernia is an internal opening or “sac” in the inguinal canal. Although both boys and girls may be diagnosed with inguinal hernias, they are far more common in boys than girls. In boys, the inguinal canal is a passageway between the abdomen and the scrotum—the sac of skin that holds the testicles on the outside of the body. The testicles are attached to a cord called the spermatic cord, which passes through the inguinal canal. In girls, the inguinal canal is the passageway for a ligament that holds the uterus in place. Often the hernia goes undetected for years because of its small size, and may not be noticed until a child is in his or her teens. Straining, coughing or crying may make the hernia more visible, but they are not the cause of the hernia. Nearly all cases of inguinal hernias are congenital (con-JEN-it-tool), meaning that they were present at birth.
This surgery closes up the opening in the abdominal (belly) wall near the groin. Inguinal hernias need to be fixed surgically to keep pieces of intestine, or bowel, from becoming stuck in the opening, causing a surgical emergency.
The surgery is done under general anesthesia (an-es-THEEZ-ya). General anesthesia makes your child’s whole body go to sleep and is needed for inguinal hernia repair so that his or her reflexes will be completely relaxed. General anesthesia makes the surgery easier and safer to do because your child will not feel any pain or have any memory of it.
Caudal (COD-ull) anesthesia is given with general anesthesia to block pain in the low back, tummy and lower trunk area and provides up to 4 hours of pain relief in that area after the surgery. Caudal anesthesia is usually intended for younger children or those having hernias repaired on both sides.
Once your child has been registered, he or she will be taken to a “holding area” where you will meet the anesthesiologist and your surgeon. A pediatric anesthesiologist—a doctor who specializes in anesthesia for children—will give the medications that will make your child sleep during the surgery. At this time, you will be able to ask any questions about the procedure.
Once questions are answered and the operating room is prepared, your child will be taken into the operating room and given an anesthetic to make him or her go to sleep.
When your child is asleep, the surgery will begin.
Children’s takes every precaution to make sure your child is safe. Risks involved in the surgery include:
There are other lesser risks, including injury to the testicle, the blood vessels to the testicle and tube (which carries the sperm). Prolonged pain is rarely seen following the repair.
When general anesthesia is needed, there are important rules for eating and drinking that must be followed in the hours before the surgery. One business day before your child’s surgery, you will receive a phone call from a nurse between the hours of 1 and 9 p.m. (Nurses do not make these calls on weekends or holidays.) Please have paper and a pen ready to write down these important instructions.
For children older than 12 months:
For infants under 12 months:
For all children:
Once your child has been registered for the surgery, a member of the anesthesia staff will meet with you to take your child’s vital signs, weight and medical history. As the parent or legal guardian, you will be asked to sign a consent form before the anesthesia is given.
While your child is asleep, his or her heart rate, blood pressure, temperature and blood oxygen level will be checked continuously.
When your child is moved to the recovery room, you will be called so that you can be there as he or she wakes up.
The most important role of a parent or guardian is to help your child stay calm and relaxed before the surgery. The best way to help your child stay calm is for you to stay calm.
After your child is discharged and goes home, he or she may still be groggy and should take it easy for the day.
Once your child is home, his or her diet should be restricted to clear liquids, such as water, Gatorade®, Popsicles® or Kool-aid®, for a couple of hours to ensure his or her stomach is settled after the surgery and the car ride home. If your child does well with liquids after a couple hours, he or she may try a light diet and soft foods such as applesauce, soup, toast, bananas, rice or hot cereal. Avoid greasy foods that stay in the stomach a long time, such as pizza and fast food. Your child may resume a normal diet the next day.
Your child should take Tylenol® or Motrin® 4 hours after the surgery to help with discomfort when the anesthesia wears off. If your child is over 5 years of age, your surgeon will give you a prescription for Tylenol with codeine elixir, in the event that your child requires additional pain medication. You do not need to fill this prescription until you see how your child is doing
After the operation, activity needs to be somewhat restricted.
If you notice a fever higher than 101.4 degrees F, bleeding or foul smelling drainage from the area around the incision, call the doctor who did the surgery right away. Also call the doctor if your child has:
If you have any specific questions about your child’s surgery, you should discuss them with the surgeon before the surgery. You may call the Division of Pediatric Surgery at Children’s and ask to speak with your child’s surgeon, or speak with him or her during the pre-surgical examination on the day of the surgery.
If your child has any special needs or health issues you feel the doctor needs to know about, please call the Division of Pediatric Surgery at Children’s before the surgery and ask to speak with a nurse. It is important to notify us in advance about any special needs your child might have.
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
UPMC Children’s Hospital of Pittsburgh
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
In addition to the main hospital, Children's has many convenient locations in other neighborhoods throughout the greater Pittsburgh region.
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