Pediatric hernias.

Almost all groin hernias in children are indirect inguinal hernias and occur as a result of incomplete closure of the processus vaginalis. The treatment is repair by high ligation of the hernia sac, which can be done by an open or laparoscopic technique. The contralateral side can be explored by laparoscopy or left alone; open exploration is no longer indicated due to the potential risk of infertility. Umbilical hernias are common in infants but usually close with time. Surgery is indicated if the umbilical hernia is symptomatic or if the fascial defect fails to decrease in size over time.