Should the processus vaginalis sac be opened or closed in pediatric herniotomy? A two-center cohort study

Two-center retrospective study of 2,257 pediatric inguinal hernia repairs found that closed processus vaginalis sac preparation was superior to open technique, resulting in significantly faster operative times and lower recurrence rates across all age groups including premature neonates. The closed technique is recommended as the preferred approach when feasible.