Intraoperative laparoscopy by a flexible scope: is it reliable in contralateral childhood hernias?
OBJECTIVE
Negative contralateral groin exploration for childhood hernias raises the question of whether contralateral groin exploration is necessary or not. To find out whether a contralateral processus vaginalis was patent, we performed laparoscopy with a flexible scope.


METHODS
After carbon dioxide insufflation, a flexible laparoscope was inserted through the opened hernia sac and the contralateral processus vaginalis orifice was examined. We considered a patent processus vaginalis as a potential hernia. The study involved 20 children: 16 boys and 4 girls. The symptomatic side was explored in a conventional manner and laparoscopy was performed through the opened hernia sac.


RESULTS
A contralateral processus vaginalis was found in 6 children: 4 boys and 2 girls. These results were confirmed by exploring the opposite groin. We did not explore if the laparoscopic examination was within normal limits. There was one false-positive result in a female patient.


CONCLUSIONS
Intraoperative non-puncture laparoscopy utilizing a flexible laparoscope through the hernia opening is an uncomplicated, reliable and precise method for identifying a patent contralateral processus vaginalis. It may represent a satisfactory alternative to routine bilateral inguinal exploration. Also, use of the flexible laparoscope may be more beneficial than use of a rigid laparoscope passed through the umbilicus or hernia sac.
Gursoy
M H
MH
Inonu University Turgut Ozal Medical Center, Malatya, Turkey.
Gurel
M
M
Koltuksuz
U
U
Uguralp
S
S
Aydinc
M
M
D002675:Child, Preschool; D005260:Female; D005336:Fiber Optic Technology; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007223:Infant; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome