Minimally invasive operation techniques for inguinal hernia: spectrum of indications in Austria

A longitudinal follow-up using the high trans-scrotal approach for inguinal and scrotal abnormalities in boys

The popular incision for surgical approach to pediatric inguinal pathologies has been the suprapubic transverse inguinal incision. Yet alternative incisions may be considered. A prospectively randomized study of a consecutive series of 256 male infants and children with various inguinal pathologies (mainly indirect inguinal hernias) were treated surgically using the "high trans-scrotal skin-crease incision," over a period of 84 months (7 years) and were compared and found to be clinically better than age- and sex-matched 278 controls with suprapubic transverse inguinal incisions for wound healing/infection, edema, seroma, hematoma, malpositioning or atrophy of testes and recurrence of the primary pathology. The results in the study group were cosmetically and clinically more favorable, and better than the control group. Nosocomial infections, complications of incarceration, and emergency surgery have resulted in an acceptable morbidity rate of approximately 5%. Popularized use of the high trans-scrotal incision and further clinical experience is recommended to facilitate even better results.