Is routine histological evaluation of pediatric hernial sac necessary?

Advocates of routine histological examination of hernial sac recommend it for surgical quality assurance, to report injuries to the vas deferens, and to detect occult malignant and benign diseases such as tuberculosis. However, the value of this routine examination is debated in this era of cost containment in health care. We conducted a retrospective study of our practice and reviewed the relevant literature to find any justification to continue this practice. Only 2.2% of hernial sacs submitted for histopathology showed unusual findings, and none of these findings were clinically important. In conclusion, the findings of our study and our review of the current literature do not support the routine histological examination of hernial sac in the pediatric age group.