Inguinal Hernia

There are 2 common types of inguinal hernias. One type is an emergency, and one type is not: 

• In a reducible hernia, the bulge comes and goes. You may see it only when your child cries, coughs, strains, runs or stands. This type of hernia doesn’t cause harm right away, but it does need surgery to prevent more serious problems.
• In an incarcerated hernia, the bulge is always present and is likely painful. This type of hernia needs treatment right away. The tissue that has slipped may be trapped. Blood supply to the tissue may be cut off, causing it to die. Or, if the intestines have slipped, they may become blocked.

Both boys and girls get inguinal hernias, but boys are 10 times more likely than girls to have one. Between 1% and 5% of newborn boys have an inguinal hernia.

At the time of surgery, we will give your child medicine (general anesthesia) to make them sleep without pain. During the surgery for inguinal hernia, your child’s surgeon makes a very small cut (incision) on the lower belly. The surgeon gently pushes any bulging tissue back into the belly. Then the surgeon sews shut the sac that poked through the tunnel in the belly.

In girls, the surgeon then sews shut the tunnel in the belly. In boys, the surgeon leaves the tunnel, which goes between the belly and the scrotum. They leave it because blood vessels for the testicles and tubes that carry sperm (vas) travel through the tunnel. The tunnel isn’t a problem; the hernia is fixed simply by closing the sac that poked through.

Finally, the surgeon will close the incision in your child’s skin.

The surgery takes about 30 to 45 minutes. Your child will be in the recovery room for 30 minutes to an hour.

Most often, your child can go home the same day as the surgery. Premature babies who have the surgery may need to stay overnight in the hospital so we can carefully watch them.

After you get home, you’ll need to keep your child’s cut (incision) clean and dry until it heals. The surgery team will teach you how to care for the incision. We will also give your child pain medicine to make them comfortable.

You will be given phone numbers so you can reach hospital staff. You can call day or night with any concerns.

A surgery clinic nurse will call you 5 to 7 days after surgery for a phone follow-up. If all is well, you don’t need to return to the clinic. If you or the nurse has any concerns about your child’s healing, we will set up a visit for you.

If your child needs surgery, you can feel confident in our expertise. Hernia Program surgeons perform several hundred inguinal hernia surgeries every year.

Some people think that surgeons who operate on adults are also experts in the surgical care of infants, children and teens. We don’t agree. Growing bodies are different from adult bodies. The way kids react to surgery – from anesthesia to IV fluids – is different from adults. Hernia Program surgeons are board certified in pediatric surgery, and the doctors who give your child anesthesia are board certified in pediatric anesthesiology.

Seattle Children’s has the only anesthesiology group in the region that has specialized training in pediatric anesthesia. Our anesthesiologists work only with children and teens, providing safe, family-centered care before, during and after surgery. Last year, the team provided anesthesia for more than 20,000 procedures at Seattle Children’s.

Most inguinal hernia surgeries are done at Seattle Children’s Bellevue Clinic and Surgery Center. From check-in through recovery, we put your child’s safety and comfort first. The operating suites are specially designed for children who need day surgeries and are healthy. Your child’s planned procedure is less likely to be delayed because complex emergency surgeries aren’t done here.

Hernia surgeries take place at the Bellevue Clinic and Surgery Center on most Fridays (3 Fridays and 1 Monday a month). On surgery day, you and your child should plan on spending about 3 hours at the Surgery Center, from the time you walk in the door to the time you leave.

The induction rooms (where your child gets anesthesia), operating rooms and recovery rooms are next door to each other. This means you’ll be able to be with your child right up until they are rolled into the operating room — and again as soon as they open their eyes in a private recovery room. Most children can go back to school 1 to 2 days after surgery. Your child cannot be treated at Bellevue Clinic and Surgery Center if: 

• They are 3 months old or younger
• They have a health problem that could increase their risk of side effects or complications while under anesthesia 

In these cases, hernia surgery is performed at Seattle Children’s hospital campus in Seattle.

During surgery, your child is given general anesthesia, which causes them to sleep without pain. Seattle Children’s also uses regional anesthesia, or regional blocks, during hernia surgeries.

With a regional block, your doctor uses ultrasound to find the nerves that supply the area being operated on. Then local anesthetics (numbing medicines) are delivered to that area through an injection or a catheter.

Regional blocks have these advantages that many parents find comforting: 

• Your child will receive a lighter amount of general anesthesia.
• Most kids will have less nausea and feel more alert after surgery.
• Your child will likely need less pain medicine after surgery. 

The effects of a regional block last about 6 hours. The surgeon will send additional pain medicine home with you to make sure your child stays comfortable.