title: Laparoscopic treatment of pediatric hydrocele and the evaluation of the internal inguinal ring.
abstract: BACKGROUND
  There are few reports of the laparoscopic findings of the internal inguinal ring (IIR) in patients with hydrocele. The purpose of this study was to assess the safety and efficacy of laparoscopic percutaneous extraperitoneal closure (LPEC) for hydrocele in comparison with that of open repair (OR) and compare the findings of the IIR between cases of hydrocele and inguinal hernia (IH).
  
  
  METHODS
  We analyzed 69 consecutive patients with hydrocele who underwent surgery at our institution between April 2009 and February 2014. The patients were divided into two groups (LPEC and OR) according to the procedure. Age, length of operation/anesthesia, and complications were compared. Concerning the findings of the IIR, we classified the features into three categories, as follows: Type 1, flat; Type 2, narrow patent processus vaginalis (PPV) with a peritoneal veil; and Type 3, widely opened PPV. We then compared these findings between the cases of hydrocele and IH treated with LPEC during the study period.
  
  
  RESULTS
  Among a total of 69 patients, 40 underwent LPEC, and 29 underwent OR. There were no significant differences in the length of operation/anesthesia and complications. No recurrences were observed in either group. The findings of the IIR were mostly classified as Type 2 (59.1%) among the cases of hydrocele and Type 3 (92%) among the cases of IH.
  
  
  CONCLUSIONS
  LPEC is a safe and effective procedure for treating hydrocele. The findings of the IIR differ between cases of hydrocele and IH.
authors: Department of Pediatric Surgery, Hyogo College of Medicine , Hyogo, Japan .
authors: Ryuta
authors: R
authors: Saka
authors: Hiroomi
authors: H
authors: Okuyama
authors: Takashi
authors: T
authors: Sasaki
authors: Satoko
authors: S
authors: Nose
authors: Chizu
authors: C
authors: Yoneyama
authors: Ryo
authors: R
authors: Tsukada
mesh_terms: D002648:Child; D002675:Child, Preschool; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007223:Infant; D007264:Inguinal Canal / Q000473:pathology*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D006848:Testicular Hydrocele / Q000601:surgery*