A hernia is when tissue or bowel finds its way through gaps in the muscles of the abdomen or groin. A hernia can often be observed as a bump or a bulge under the skin where it exists. Hernias do not spontaneously resolve on their own and require surgical intervention to prevent damage to the intestine and allow for pain-free movement of the muscles affected. The major concern with any hernia is that the organs that pass through the wall may become incarcerated, or strangled.
Inguinal hernias are the most common hernias and the most common surgical problem of children. The inguinal ring is open in fetal life and closes around the time the baby is born. However, in some children, this ring does not close or does not close completely, which leaves space for bowel or an ovary to come through the inguinal ring into the groin. It usually appears as a bulge on the groin and can appear to get more prominent when the child strains or cries. To prevent injury and organ death to the parts that pass through the inguinal ring, it is important to have the hernia repaired as soon as possible.
Pediatric inguinal hernia repair surgery is generally quick and relatively not very invasive. The pediatric surgeon can usually remove the herniated organs back into place and close the opening in the inguinal ring laparoscopically, through two or three tiny incisions or through a small (generally about an inch) incision. Find more information about inguinal hernia repair at Alaska Pediatric Surgery here.
Epigastric hernias are those that occur when tissue or organs protrude through the abdominal wall in the epigastric area (above the belly button and below the breastbone). Epigastric hernias may be present at birth and, for the most part, don’t cause many issues. They are usually small and only the lining of the abdomen breaks around the surrounding tissue. However, sometimes part of the stomach may push through, which can cause major problems. Epigastric hernias will not repair themselves and must be corrected surgically.
Pediatric epigastric hernia repair surgery is typically performed on an outpatient basis and is a quick procedure with very little risks. The pediatric surgical team will remove herniated organs and close the opening in the abdominal wall laparoscopically. For more information about epigastric hernia repair surgery at Alaska Pediatric Surgery, read here.
Umbilical hernias are fairly common in children and may be present at birth. Umbilical hernias are a result of the abdominal wall not completely closing during the infant’s development and allows part of the intestine to come through. This is seen as a bulge at the belly button that may look bigger when the child strains or cries.
Approximately 90 percent of umbilical hernias close on their own by the time the child is five. Many times it will be recommended to wait until the child is five before surgical intervention. If, however, the hernia is large, painful, or causes incarceration (strangulation) of the intestines, it is considered a medical emergency that must be treated with hernia surgery as soon as possible. For more information about pediatric umbilical hernia repair at Alaska Pediatric Surgery, read here.
External Catheter and Port Placement and Removal
For children who require frequent intravenous infusions of medication, blood products, or nutrition, or require frequent blood sampling, a long-term intravenous catheter may be recommended. The benefit of a long-term catheter is that they reduce the number of needle sticks the child receives and reduces the risk of infection and vein damage when caustic medications such as chemotherapy or antibiotics are administered. There are two types of long-term central venous catheters, or central lines, that may be used: an external catheter (Broviac® or Hickamn®) or a totally implanted catheter, port, (Portacath® or Mediport®).
An external catheter leaves a tube that hangs out of the placement incision in the skin. An internal port is implanted under the skin and is accessed with a special needle as needed. Both types of central lines are placed by a pediatric surgeon in the operating room and can be removed in an outpatient procedure.
For all of your child’s surgical needs, trust Alaska’s most experienced pediatric surgeon — Dr. Roaten and his team at Alaska Pediatric Surgery. To schedule your consult, contact our office today!