Laparoscopy Through the Open Ipsilateral Sac to Evaluate Contralateral Patent Processus Vaginalis in Children with Clinical Unilateral Inguinal Hernias

Ha, Yong Won; Yoon, Yool Ro; Sul, Chong Koo

Abstract

PURPOSE: Laparoscopy through the open ipsilateral hernial sac to evaluate the contralateral side in boys with unilateral inguinal hernia has been criticized because of some risk and cost. Laparoscopic evaluation of the contralateral side was modified to avoid abdominal trocar insertion by using the open ipsilateral hernia sac for instrumentation. This study was performed to determine the usability, safety, and effectiveness of this technique.
MATERIALS AND METHODS
Forty-two boys with unilateral inguinal hernia and hydrocele were evaluated using open hernial sac for diagnostic laparoscopy of the contralateral side at the time of inguinal herniorrhaphy.
RESULTS
The mean age was 3.8 years. The presenting hernia was right-sided in 29 (69.0%) cases and left-sided in 13 (31.0%) cases. Based on the result of diagnostic laparoscopy 32 (76.2%) cases were negative on the contralateral side, and 10 (23.8%) were positive. After the contralateral exploration of the positive groups, 9 (90.0%) showed contralateral patent processus vaginalis. After undergone the high ligation of the patent processus vaginalis at the internal inguinal ring.
CONCLUSIONS
Laparoscopic evaluation of the contralateral side via the open ipsilateral hernial sac is feasible, quick, safe, and cost effective. It requires no additional incision. Long-term follow up is required to determine the ultimate effectiveness of this method.