title: Intraoperative laparoscopy by a flexible scope: is it reliable in contralateral childhood hernias?
abstract: 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.
authors.affiliation: Inonu University Turgut Ozal Medical Center, Malatya, Turkey.
authors.forename: M H
authors.initials: MH
authors.lastname: Gursoy
authors.forename: M
authors.initials: M
authors.lastname: Gurel
authors.forename: U
authors.initials: U
authors.lastname: Koltuksuz
authors.forename: S
authors.initials: S
authors.lastname: Uguralp
authors.forename: M
authors.initials: M
authors.lastname: Aydinc
mesh_terms: 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