Laparoscopic evaluation of contralateral patent processus vaginalis in children.
BACKGROUND
Routine contralateral inguinal exploration following unilateral herniorrhaphy in children remains controversial. Contralateral patent processus vaginalis (PPV) incidence decreases from 80% in young infants to about 20% to 30% in the adult population. However, the incidence of a clinical hernia appearing subsequently following unilateral herniorrhaphy is 6% to 10%.


METHODS
Fifty consecutive children were evaluated by diagnostic laparoscopy (DL) at the time of inguinal herniorrhaphy.


RESULTS
The mean age was 3 years. Thirteen of 42 patients (31%) with a symptomatic confirmed hernia had a contralateral PPV by DL. The mean operating time was 48 minutes. The sensitivity was 98% with a specificity of 100%. No child suffered a complication due to DL.


CONCLUSIONS
We found diagnostic laparoscopy in children with evidence of unilateral inguinal hernia (1) was safe, (2) revealed a 31% incidence of contralateral PPV, and (3) eliminated the need for contralateral exploration in 69%.
Pellegrin
K
K
Children's Hospital, Denver, Colorado, USA.
Bensard
D D
DD
Karrer
F M
FM
Meagher
D P
DP
D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D015994:Incidence; D007223:Infant; D007432:Intraoperative Period; D010535:Laparoscopy; D008297:Male; D012680:Sensitivity and Specificity