To explore the clinical efficacy and postoperative follow-up results of high ligation of hernia sac through concealed small incision in the treatment of inguinal hernia and communicating hydrocele in children, and to provide reference for children with inguinal hernia or communicating hydrocele.

The clinical data of 820 children (a total of 896 surgical procedures) with inguinal hernia or hydrocele treated by concealed small incision surgery from December 2010 to December 2024 were retrospectively analyzed. The operation time, intraoperative blood loss, postoperative complications, recurrence rate and incision aesthetics were collected. Vancouver Scar Scale (VSS) was used to evaluate the incision scar at 1 year after operation.

The average operation time of unilateral surgery was (8.2±4.5) min, and that of bilateral procedures was (14.3±5.8) min. The intraoperative blood loss was less than 5 mL. The total incidence of postoperative complications was 0.22%(2/896). The ipsilateral recurrence rate was 0.67% (6/896), and the contralateral recurrence rate was 1.34%(12/896). One year after the operation, 685 cases were followed up. The VSS evaluation results indicated that the score of 0 (no visible trace) accounted for 67.2%, score of 1-3 (slight trace) accounted for 27.7%, and score ≥4 (visible scar) accounted for 5.1%. There was no persistent postoperative pain or cryptorchidism during the follow-up period.

High ligation of concealed small incision hernia sac has the advantages of short operation time, small trauma, fast recovery, beautiful incision and low incidence of complications. It is a safe and effective surgical method for the treatment of inguinal hernia or communicating hydrocele in children, especially for children in primary care settings or specific anesthesia contraindications.