Neonatal Surgery
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Reviewed by Charge Nurse - Newborn, Carl Kuschel and Mr Phil Morreau (Surgery) |
| April 2005 |
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| Preoperative Care | Postoperative Care | Index of Related Documents |
Inguinal herniae are common in preterm infants. They result from failure of closure of the processus vaginalis - a covering or peritoneum that encloses the testicles during their descent into the scrotum. Bowel is able to enter the inguinal canal. They are most common in males (90%), and up to 15% of infants will have bilateral herniae (in preterm infants, it is common to repair both sides even if a hernia is present on one side). A palpable hernia in a female could represent an ovary.
It is important to differentiate between a hernia and a hydrocoele. In a hernia, bowel enters the inguinal canal. There is a mass at the inguinal ring which can usually be reduced. Hydrocoeles are collections of fluid within the processus vaginalis and scrotum - one can palpate above them, they transilluminate, and are irreducible.
to view a video (1.2MB) demonstrating how to reduce an inguinal hernia.
Follow the steps below for pre-operative care of baby with inguinal hernia.
| Steps | Action |
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1 |
Follow standard steps for preoperative care. |
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2 |
If difficult to reduce, call the on-call surgeon or surgical registrar. |
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3 |
If still irreducible, will require surgery. |
| 4 | If reduces keep overnight and operate next day as acute. |
| 5 | If <44 weeks for full term or <60 weeks for preterm keep on ward for one day on apnoea monitor then home with GP visit in one week. |
| 6 | Discuss with parents of child:
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Follow the steps below to ensure safety of baby post-operatively.
| Steps | Action |
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1 |
Follow standard steps for postoperative care. |
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2 |
Observe wound for signs of bleeding, excess bleeding is reported to doctor/NS-ANP. |
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