Hernia Exploration oR Not In Infants Analysis
Hernia Exploration oR Not In Infants Analysis
This study evaluates the effectiveness and cost-effectiveness of contralateral surgical
 exploration during unilateral inguinal hernia repair in children younger than six months with
 a unilateral inguinal hernia. In half of the participants contralateral exploration will be
 performed, while in the other half only unilateral inguinal hernia repair will be performed.
There is a high incidence of metachronous (i.e. a second) contralateral inguinal hernia
 (MCIH) in infants with an inguinal hernia (5-30%, most studies report 10%), with the highest
 risk in infants aged less than 6 months. Metachronous hernia is associated with the risk of
 incarceration and general risks and costs of a second operation. This can potentially be
 avoided by contralateral exploration at the first operation. On the other hand contralateral
 exploration may turn out to be unnecessary, is associated with additional operating time and
 cost, and may be associated with additional complications of surgery (including testicular
 atrophy, wound infection) and anesthesia. Both policies to routinely explore the
 contralateral side or not are used in the treatment of unilateral inguinal hernias in
 children. There is no high-grade level of evidence of the superiority of one of either
 policy.
Inclusion Criteria:

 Infants aged younger than six months at first presentation with a primary unilateral
 inguinal hernia undergoing open hernia repair are considered eligible for inclusion.

 Exclusion Criteria:

 Infants with (1) incarcerated inguinal hernia requiring urgent surgery, (2) a
 ventricular-peritoneal drain, (3) non-descended testis.