Pediatric hernia
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Accessory Breast
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:: Damsoyu hospital > Specialized Clinics > Pediatric Hernia ::

소아탈장

담소유외과는 진정한 외과전문병원 리더가 되기 위해 가장 먼저 도전하고 노력합니다.

소아탈장의 치료는?

Among the types of pediatric hernias, the umbilical hernia, and ventral hernia spontaneously resolve on its own. Often the treatment waits till the age around 5. However, inguinal hernia has chance of incarceration and necrosis. This is why when the child is diagnosed as inguinal hernia; the surgery needs to be performed immediately. Incarnation is a state when the organ gets stuck in the opening of hernia. If incarceration continues, the poor circulation of blood may lead to necrosis.

사진-생후 14일된 신생아로 소장이 괴사되기 직전/대장이 교액 직전/괴사(교액)된 장기가 음낭에 꽉참/난소가 교액되어 난소 적출/왼쪼 난소가 교액된 여아

This is why when the child is diagnosed as inguinal hernia; the surgery needs to be performed immediately, not waiting till the child is grown up.

담소유외과의 소아탈장 수술은?

For both pediatric and newborn hernia, we perform laparoscopic surgery. The surgery is around 15 minutes and at one-stop, consultation, surgery, and discharge on the same day will be carried out. There are many advantages of pediatric laparoscopic hernia surgery, compared to laparotomy but we would like to explain some of the benefits. Dam So Yu Hospital performed the most pediatric surgeries among hospitals in Korea.

5692 Cases of Dam So Yu Hospital’s Laparoscopic Hernia Surgery
담소유외과 복강경 소아수술 5692례
Number of Patients(%) Weight(Kg) Surgical Duration(min) Both Incarcerated
Total 5692 111.61(2%) 87.7(1.5%)
0~3months 1040 5.14 16.1 834

108
3~12months 543 9.27 15.5 317 31
1~2years 848 11.2 14.7 563 8
2~5years 1515 15.2 13.1 977 7
5~10years 758 22.1 12.2 450 5
10~18years 76 48.7 16.1 35 35
18years~ 912 50

담소유소아탈장 서혜부탈장 수술통계(2014)

소아탈장의 재발 / 1.타 병원의 개복(절개) 소아탈장 수술 - 재발률:3.2% (2010~2012년 대한민국), 이시성 반대쪽 탈장 : 5~10% / 2.담소유외과의 복강경 소아탈장 수술 - 재발률:0.18% (2275명 중 4명, 담소유외과) , 2014년 이후 재발없음, 이시성 반대쪽 탈장 : 0% / 3. 타병원 개복수술 수 담소유외과에서 재수술 - 재수술:2.9%, 64명 (2275명 중 66명)

First, the structure inside the abdominal is checked which makes it possible to perform safe surgery.

At other hospitals, hernia sac is exfoliated and tied to the opening of the stomach. Next to hernia sac, cord and vas deference is located where sperms mobile. There is a chance of blood vessels and vas deference getting wounded.
If the surgeon is a pediatric hernia surgery specialist, there is a very low chance of injury. However, surgeons who mostly perform adult hernia surgery, has high chance of injuring the child.

사진-남아 소아탈장수술

The hernia sac and bladder has similar looking mesh. Because of the similar appearance, there is a chance that bladder might be injured. Laparoscopic surgery checks the structure with the camera so the surgery is much safer.

Second, there is a very low chance of recurrence.

The recurrence after going through surgery, in medical terms, means that hernia has formed again on the area where hernia surgery was performed. According to the statics in Korea, from 2010 to 2012, hernia surgery was performed at other hospitals 80,472 times and recurrence case of hernia is 2605 which is about 3.2%.

타 병원 개복수술 후 재발
개복수술 후 재발에대한 이미지
The young patients that I performed surgery on had 0.43% of recurrence three years ago and about two years from now on, no recurrence has occurred. The recurrence after going through surgery, in medical terms, means that hernia has formed again. Often hernia is formed on the other side where surgery hasn’t been performed. This is known as 이사성대측 탈장, and parents call it this sign as recurrence on the other side.
타 병원 수술 후 반대쪽 재발
개복수술 후 반대쪽 재발에대한 이미지
Hernia opening may be on both sides of but signs may only appear on the one side. This is why other hospitals perform surgery only on one side. However, when performing surgery, case of having hernia on both sides is very common, which is about 63%. This is why hernia recurrence may occur on the other side after undergoing surgery.
타 병원 수술 후 반대쪽 재발
개복수술 후 반대쪽 재발에대한 이미지
In laparoscopic surgery, both sides are checked and tied at the same time to eliminate the chance of recurrence on the other side.
담소유외과 복강경 양쪽탈장수술
Take a look at the image on the left. The symptom of hernia was on the right side but the size hernia opening is larger on the left. This is why undergoing surgery at other hospitals can lead to recurrence. The percentages of patient with hernia opening on the both sides were about 40.6%. Cases like this have very high possibility of recurrence of pediatric hernia on the other side.
The third is pediatric hydrocele accompanied with hernia for boys.
Pediatric hydrocele requires surgery for children over age of 2. Children who are under 2 years old have high possibility of resolving on its own so treatment/surgery is waited.
If hydrocele accompanies, the laparoscopic surgery is done at the same time and Dam So Yu Hospital is the only hospital that can conduct two laparoscopic surgeries at one time.
왼쪽 탈장구멍 증상은 없지만 오른쪽보다 구멍은 큼, 오른쪽 탈장구멍 증상 있는 쪽이지만 왼쪽보다 작음(이미지)

국내 유일의 음낭수종/잠복고환 동시 수술 가능

정삭의 음낭수종 복강경수술
정삭의 음낭수종을 복강경수술로 완전히 제거, 물주머니를 모두 제거하고 탈장구멍을 막고 수술을 마침
The fourth is surgery performed at same time for boy patients accompanying cryptorchidism.
Cryptorchidism occurs when the testicle is not fully descended on the scrotum and stays in between.
소아 잠복고환
잠복고환에 대한 이미지
The chance of having cryptorchidism is higher if the child is premature or under-weight. After 3 months of birth, testosterone of blood concentration rapidly increases. During this period, the descending of testicle occurs. When the child turns the age of 1, the percentage of testicle descend is about 0.8% and during puberty and adulthood, change does not occur. It simply means that the natural stage of descendent will no longer occur after a certain period. The deeper testicle is placed in the abdominal, the more damage it does. After the age of one year and six months, a lot of changes in the cell happen. This is why the treatment should be done around the age of one before the body starts going through changes. If cryptorchidism or undescended testicle does not get treated, it could result in sterility and psychological problems may occur after the patient is grown up. It also increase the chance of having testicular cancer so surgical repair to descend the testis is crucial.
소아 잠복고환의 수술
수술 순서에 대한 이미지(고환을 음낭으로 내리고 탈장구멍을 막음)

The Fifth is ovarian hernia which occurs to girls.

The common case for girls with ovarian hernia is that the location of uterus has been moved closer to the hernia. Not only uterus, but fallopian tube also turns upwards which is common.

난소탈장 수술
수술 이미지
The ovary should not be placed where inserted camera can see.
난소와 자궁의 정상위치
정상위치 이미지 - 자궁은 방광밑에 숨겨져 있어 안보여야 정상
However, it is placed in the upper side to enter and leave the hernia opening. Ovarian hernia patients with inguinal hernia account about 20%. Other hospitals cannot check the internal state of the abdominal so they cannot place uterus back in its right place.
타 병원 수술의 난소탈장수술
서혜부쪽에 난소가 안보이고 아무조직도 없는게 정상소견, 난소탈장 개복수술 후 자궁과 난소의 위치가 서혜부 쪽으로 당겨져 있음 정상은 안보여야 함
With laparoscopic surgery, we perform two surgeries at the same time: removing the cause of tilted uterus and bringing it back to its’ original place.
난소탈장수술
이미지 - 서혜부쪽에 난소가 안보이고 아무조직도 없는게 정상소견, 복강경 난소탈장수술에서 자궁과 난소의 위치를 정상으로 만들기 위해 광인대를 박리
이미지 - 난소탈장이 아닌 서혜부 탈장, 복강경 소아탈장 수술에서 탈장 구멍만 묶어줌
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