What is hernia repair surgery in children?

Most hernias are a weak spot in the belly muscles. This weakness can allow a piece of the intestines or the tissue around them to poke through. A hernia may hurt when your child strains with a bowel movement or lifts something heavy. It may also hurt when your child is active. But some hernias don't cause pain.

Sometimes an organ or tissue gets stuck in the hernia. This can cause serious problems. A hernia repair prevents that from happening.

There are several types of hernias. Umbilical hernias occur when intestine, fat, or fluid pushes through a weak spot in the belly near the belly button. Other types of hernias in the belly include epigastric (near the stomach), ventral (in the middle of the belly), and incisional (where a surgical cut was made). Inguinal and femoral hernias occur in the groin area. Some babies are born with a diaphragmatic hernia. It's an opening in the large muscle (diaphragm) between the lungs and belly.

A doctor can fix a hernia through a cut (incision). This is called open surgery. Or the doctor may make some small cuts and use a thin, lighted scope and small tools. This is laparoscopic surgery. If your child's hernia is bulging, the bulge is pushed back into place. The doctor then sews the healthy tissue back together. Sometimes a piece of material is used to patch the weak spot.

Open surgery will leave a bigger scar. Laparoscopic surgery leaves a few small scars. The scars will fade with time.

The time it takes for your child to heal depends on the type of hernia. Your doctor will tell you when your child can return to normal activity.

Activity

• Allow your child's body to heal. Don't let your child move quickly or lift anything heavy until he or she is feeling better.
• Have your child rest when he or she feels tired.
• Have your child try to walk a little each day.
• The time it takes for your child to heal depends on the type of hernia. Your doctor will tell you when your child can return to normal activity.
• Your child may shower 48 hours after surgery, if the doctor okays it. Pat the incision dry. Your child should not swim or take a bath for the first 2 weeks, or until the doctor tells you it is okay.

Diet

• Your child can eat a normal diet. If your child's stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• If your child's bowel movements are not regular right after surgery, you can help him or her to avoid constipation and straining. Have your child drink plenty of water. The doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.
• Be safe with medicines. Have your child take medicines exactly as prescribed. Call your doctor if you think your child is having a problem with his or her medicine. You will get more details on the specific medicines your doctor prescribes.

Incision care

• If your child's cut (incision) was closed with skin glue, the glue will wear off in a few days to 2 weeks. Do not put antibiotic ointment or cream on the glue.
• If there are strips of tape on the cut the doctor made, leave the tape on for a week or until it falls off.
• If there are staples closing the cut, you will need to see the doctor in 1 to 2 weeks to have them removed.
• Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
• You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing. Change the bandage every day.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery. Tell your child that the surgery will help the bump go away. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child. Ask if a child life specialist is available.
• Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

The day before surgery

• A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
• Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the surgery may be canceled. If the doctor told you to have your child take his or her medicines on the day of surgery, have your child take them with only a sip of water.
• See that your child has bathed. Do not apply lotion or deodorant.
• Your child may brush his or her teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that reminds him or her of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by the anesthesia provider. Your child will be asleep during the surgery.
• The surgery can take about 30 minutes to 2 hours or more.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery room staff will monitor his or her condition. The doctor will talk to you about the surgery.
• Depending on the type of surgery, you may be able to take your child home after the surgery. For more involved surgeries, your child may stay in the hospital for a few days.