Modified Mitchell-Banks Technique in Pediatric Inguinal Hernia Repair: A Personalized Surgical Approach

Background: The study aims to assess the effectiveness of the modified Mitchell-Banks technique with external oblique aponeurosis preservation in pediatric inguinal hernia surgery while examining the connection between internal inguinal ring diameter and demographic data and anthropometric measurements and complications and its suitability for various age groups. Method: A single centre conducted a retrospective study from 1 October 2024 through 1 May 2025 which included 110 patients between 0 and 18 years of age. The patients received classification based on their age range (0–2, 2–5, 5–10, 10–18 years) and their ethnic background (Syria, Turkish Republic) and their complication status. The internal inguinal ring diameter, demographic data, and clinical findings were compared. Results: The mean age was 4.79 ± 4.02 years. 83.1% of the patients were male, and 60.9% were Syrian. The mean internal inguinal ring diameter was 8.59 ± 4.86 mm. In patients with complications (19.1%), the internal inguinal ring diameter was wider (10.88 ± 7.03 mm vs 7.31 ± 3.87 mm; p = 0.0344). The complication rate increased with decreasing age (0–2 years: 45.7%; 2–5 years: 12.9%; 5–10 years: 4.0%; 10–18 years: 0%; p < 0.0001). The study revealed a negative relationship between internal inguinal ring diameter measurements and patient height (r = -0.194, p = 0.0418) and a positive relationship between BMI and height (r = +0.188, p = 0.0488). The study revealed no cases of recurrence or surgical site infection or testicular atrophy among the patients . Conclusion: The modified Mitchell-Banks technique provides a secure surgical approach which achieves both low complication rates and high success rates while maintaining complete anatomical integrity for all pediatric age ranges. The development of complications depends on both the internal inguinal ring diameter and the patient's age.