Stockholm Hernia Center has long experience of Pediatric Surgery such as surgery of non-migrated testicles and groin hernias. We operate both diagnoses with both laparoscopic and open technique. There is also a wide experience of pediatric anesthesia at the clinic.
Groin hernia in children differs from groin hernia in adults as there is no underlying rupture in the abdominal wall. In children, there is an open connection between the abdominal cavity and the groin that can extend down into the scrotum of boys and the major labia of girls. It is found in about 3-5% of all children and is 10 times more common in boys.
A groin hernia usually appears as a lump in the groin that protrudes as the child increases the pressure in the abdomen (e.g. crying). The increased abdominal pressure depresses the intestine in the hernia. At 15% there is a hernia on both sides. Groin hernia does not disappear spontaneously but needs surgery.
The risk with a groin hernia is intestinal damage due to an incarceration (i.e. the intestine gets stuck in the hernia). In most patients, even small children, the hernia can be repaired with a laparoscopic operation. However, sometimes an open operation may be preferred.
The testicles are formed during fetal life inside the abdominal cavity. From where, they migrate down to the scrotum through the inguinal canal, usually during the last third of the fetal period. However, in 3 - 5% of all newborn boys, one or both testicles have not moved down normally but remain inside the abdomen or groin. At six months, the figure is 1%. After that, the proportion of testicles that migrate down spontaneously is extremely small.
A testicle that does not migrate down normally has an increased risk of developing testicular cancer and may result in impaired sperm production. It is important to operate and move the testicle to the right place as soon as possible as it develops better in the scrotum. It is recommended to do the surgery for this between 10 - 18 months of age. This is done with so-called orchidopexia.
If the testicle remains inside the abdominal cavity, two laparoscopic operations are often required to bring it down to the right place, while a single open operation for the testicles found in the groin is sufficient.
Anesthesia of children
Allowing your child to be operated feels nervous for most parents and we do our utmost to make you as a family feel safe and well cared for. On an initial visit, an investigation and assessment is made and we discuss and explain any possible intervention. If an operation is planned, it is always performed with anesthesia. You can usually go home the same day. A post-operative visit is booked to a few months after surgery.