AB009. SOH26AB_0445. Paediatric inguinal hernia repair: operative technique and key differences from adult surgery

Abstract: Paediatric inguinal hernias differ fundamentally from adult hernias. In children, hernias are almost exclusively indirect, resulting from a patent processus vaginalis, and carry a higher risk of incarceration, particularly in younger patients, necessitating timely repair. In contrast, adult hernias are frequently direct and associated with acquired abdominal wall weakness. Despite the frequency of paediatric hernia repair, high-quality operative videos illustrating paediatric-specific principles remain limited. We present a video of an open inguinal hernia repair in a 7-year-old boy to highlight the key distinctions between paediatric and adult hernia surgery. The video demonstrates the essential steps of paediatric hernia repair, including inguinal exposure, identification and safe mobilisation of the indirect sac, protection of the vas and vessels, and high ligation. The accompanying discussion will emphasise evidence-based differences between paediatric and adult hernia management, including the avoidance of mesh in children and how paediatric anatomy shapes operative decision-making. The footage provides a clear visualisation of the paediatric inguinal canal and key operative nuances. Practical techniques to minimise complications and optimise outcomes are demonstrated. A video presentation of paediatric inguinal hernia repair, supplemented by live commentary, is an effective educational tool for trainees. Emphasising the contrasts with adult hernia surgery reinforces age-specific surgical principles and supports standardised, evidence-based paediatric practice.

Keywords: Educational technology; hernia; inguinal; paediatrics; surgical procedures