What is the sheath process?
It is a passage that leads from the belly to the groin area (above the base of the thigh) and continues downward. Girls can pass under the skin of the labia majora, and boys can pass to the scrotum. Everyone has this channel during the fetal period, but most people are closed after birth.
If this tube remains unclosed or is not tightly closed and then opened, the contents of the stomach (intestines, omentum, ovaries, Merkel's diverticulum, appendix, etc. or ascites) may enter the groin area through this channel , Down can also enter the labia majora (girls) or scrotum (boys).
boy's sheath
Image Source：Doctor Sun Pediatric Surgery
girl's sheath
Image Source：Doctor Sun Pediatric Surgery
When the duct is too large and the intestines, omentum, ovaries, Meckel's diverticulum, appendix, etc., come down, it is called indirect inguinal hernia；When the tube is too small and only ascites comes down, it is called hydrocele.
Indirect inguinal hernia and hydrocele are essentially the same in their pathogenesis, and both are not closed.The principles and methods of surgical treatment are essentially the same, both of which are high ligation of sheath-like processes.Seal this passage, the contents in the stomach will no longer come down, and the purpose of healing will be achieved.
The methods of surgery are divided into open surgery and laparoscopic surgery.To put it simply, open surgery is like repairing the leak from the outside of the barrel, while laparoscopic surgery is like repairing the leak from the inside of the barrel.
Laparoscopic surgery
Open surgery
Image Source：Doctor Sun Pediatric Surgery
More and more hospitals are focusing on laparoscopic surgery and gradually abandoned open surgery.What is the reason? Is open surgery bad? No, the effective rate and recurrence rate of the two are very close.
From a technical perspective alone, "the ruler is shorter, the inch is longer."The biggest advantage of open surgery is that it does not interfere with the abdominal cavity. For unilateral surgery, a beautiful open surgery is definitely more minimally invasive, and the scar can be very inconspicuous.The biggest advantage of laparoscopic surgery is the ability to find that the contralateral recessive sheath process is not closed (Note: The recessive sheath process is not closed means that there is a sheath process that is not closed, but has not yet manifested an indirect inguinal hernia or sheath Effusion), and for girls and bilateral surgery, laparoscopy is still more advantageous.
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