title: Is there an increased risk of complications with laparoscopy looking for a contralateral patent processus vaginalis?
abstract: BACKGROUND
  In young children with a unilateral congenital inguinal hernia, the relatively high incidence of an occult contralateral patent processus vaginalis (CPPV) has led to the practice of laparoscopic contralateral exploration. The effect on postoperative complications such as surgical site infection from performing the laparoscopy has not been previously reported.
  
  
  METHODS
  A retrospective review was conducted on all patients who underwent a unilateral inguinal hernia repair from January 1, 2000 to March 1, 2010. We compared those children who underwent laparoscopic evaluation of the contralateral inguinal ring with those who did not. Patient demographics and operative data outcomes were evaluated. Student's t test was used to compare continuous variables, and the chi-squared test with Yates's correction was used for discrete variables.
  
  
  RESULTS
  There were 1164 patients who underwent a unilateral inguinal hernia repair during the 10-year study period, and laparoscopy was used in 1010 patients. There were no intraoperative complications from the laparoscopy. In the group who underwent laparoscopy, the mean age was 4.0±3.6 years old, and 88% were male. At laparoscopic exploration, 315 (31%) patients were found to have a CPPV. There were 10 patients (1.0%) who developed a surgical site infection. Infection developed in the side used for laparoscopic exploration in 9 patients and in the contralateral side in 1 patient. All patients with surgical site infections were treated initially with oral antibiotics. Abscesses developed in 2 patients, requiring incision and drainage. No patient required hospital admission or reoperation. In the 154 patients who did not undergo laparoscopy, mean age was 4.3±4.4 years (P=.35), and 85.8% were male (P=.54). There was one wound infection identified in this control group (0.6%) (P=1.00). There was no difference in rate of recurrence (control group, 0%; exploration group, 0.6%; P=.72).
  
  
  CONCLUSIONS
  There is minimal risk of infection or recurrence following unilateral inguinal hernia repair, and this risk is not increased with the use of contralateral exploration using laparoscopy.
authors.affiliation: Department of Surgery, Children's Mercy Hospital and Clinics, Kansas City, MO, USA.
authors.forename: Vincent E
authors.initials: VE
authors.lastname: Mortellaro
authors.forename: Alessandra C
authors.initials: AC
authors.lastname: Gasior
authors.forename: E Marty
authors.initials: EM
authors.lastname: Knott
authors.forename: Sohail R
authors.initials: SR
authors.lastname: Shah
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Ostlie
authors.forename: George W
authors.initials: GW
authors.lastname: Holcomb
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
mesh_terms: D002675:Child, Preschool; D005832:Genital Diseases, Male / Q000150:complications / Q000175:diagnosis*; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment