Comparison of Ferguson and Gross herniotomy with Mitchell Banks’ herniotomy in boys older than two years

Abstract

Background & Objective: In children younger than two years, most surgeons perform the inguinal herniotomy superficially through the external ring, a technique known as Mitchell-Banks’ Herniotomy (MBH) while in older children, commonly Ferguson and Gross Herniotomy (FGH) is performed which involves opening of inguinal canal. Our aim was to compare the FGH and MBH in terms of recurrence in boys with inguinal hernia.
 Methods: Boys with inguinal hernia presenting to Pediatric Surgery, Mayo Hospital Lahore from Dec 2016 to January 2018 were included in the study, if older than two years and younger than 14 years and without palpable deep ring (2 cm or more in width) or strangulation of inguinal hernia or malnutrition. They were randomly allocated in 2 groups after obtaining informed consent from parents, and underwent MBH (Group-A) and FGH (Group-B). Children were called for follow up after 1 week and at 6 months to assess for recurrence.
 Results: Total 260 patients with inguinal hernia were enrolled (NCT:03392636). The mean age of boys in Group-A was 5.2±3.0 years and in Group-B was 5.9±3.1 years. Mean operating time in Group-A (26.65±3.22 minutes) was longer than Group-B (15.92±4.22 minutes), and scrotal oedema was noted in 38 (29.2%) cases in Group-A, while 7 (5.4%) cases in Group-B. Testicular atrophy was noted in one patient of Group-B. Recurrence occurred in 1(0.8%) patient in Group-A, and in 8(6.2%) patients in Group-B (p-value 0.018).
 Conclusion: Mitchell-Banks’ herniotomy has lower recurrence rate than Ferguson and Gross Herniotomy in boys older than two years.
 doi: https://doi.org/10.12669/pjms.37.1.3216
 How to cite this:Ahmad HM, Naumeri F, Saud U, Butt G. Comparison of Ferguson and Gross herniotomy with Mitchell Banks’ herniotomy in boys older than two years. Pak J Med Sci. 2021;37(1):40-44. doi: https://doi.org/10.12669/pjms.37.1.3216
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Analysis of inguinal hernia in children: Experience of a single institution with 1185 cases

“…It has been reported that Mitchell-Banks herniotomy and modi ed Ferguson methods can be safely used in patients younger than two years of age [10]. In addition, it has been reported that Mitchell-Banks herniotomy reduces the recurrence rate in patients older than two years of age [11]. The fact that indirect hernia was detected in all of our patients in our study supports that inguinal hernia in children develops when the processus vaginalis remains open towards the inguinal canal [12].…”