The Contribution of Intraoperative Transinguinal Laparoscopic Examination of the Contralateral Side to the Repair of Inguinal Hernias in Children

Overview

Journal World J Pediatr

Specialty Pediatrics

Date 2010 May 22

PMID 20490767

Citations 7

Authors

Baruch Klin

Yigal Efrati

Ibrahim Abu-Kishk

Sorin Stolero

Gad Lotan

Affiliations

Soon will be listed here.

Abstract

Background: Bilateral inguinal hernias are relatively common in children. This fact has led to a controversy of more than 50 years concerning the necessity of bilateral surgical exploration during the repair of unilateral inguinal hernias in children. The advent of transinguinal laparoscopic visualization of the contralateral side is a turning point and a major contribution to the subject, offering the opportunity to reassess the systematic bilateral exploration and the "wait and see" policies currently in use at most services of pediatric surgery.

Data Sources: The current information concerning intraoperative transinguinal laparoscopic evaluation of inguinal hernias in children was summarized in a didactic way. A MEDLINE search (PubMed) from 1995 to the present days was conducted.

Results: A patent processus vaginalis (PPV) is not equal to a future symptomatic hernia. There is still no definitive evidence on which PPVs will become a hernia (5.8% to 11.6%) and which remain clinically insignificant. Diagnostic intraoperative transinguinal laparoscopic evaluation of the contralateral side is today the most simple and accurate way to reduce the incidence of negative explorations.

Conclusion: Diagnostic intraoperative transinguinal laparoscopic evaluation of the contralateral side during pediatric inguinal hernia repair is a simple, accurate, fast, and effective method to assess the contralateral processus vaginalis, improving decision-making, reducing the number of negative explorations, and sparing the surgeon the embarrassment associated with the appearance of a metachronous hernia at a later date. It is easily learned and should be part of every pediatric surgeon's practice.

Citing Articles

Single-incision approach for bilateral inguinal hernia repair in children: A retrospective study.

Chongxi R, Hongqiao W, Fengying L, Xin W, Hongxia Q, Lijun X Medicine (Baltimore). 2020; 99(9):e19376.

PMID: 32118783 PMC: 7478388. DOI: 10.1097/MD.0000000000019376.

Frequency of inguinal herniotomy in Australia (1998-2017).

Vikraman J, Donath S, Hutson J Pediatr Surg Int. 2019; 35(7):759-763.

PMID: 31111217 DOI: 10.1007/s00383-019-04483-4.

Reliability of Preoperative Inguinal Sonography for Evaluating Patency of Processus Vaginalis in Pediatric Inguinal Hernia Patients.

Namgoong J, Choi W Int J Med Sci. 2019; 16(2):247-252.

PMID: 30745805 PMC: 6367528. DOI: 10.7150/ijms.28730.

Patent Contralateral Processus Vaginalis in Infants and Children: Is Herniotomy Justified?.

Zakaria O Oman Med J. 2018; 33(6):481-485.

PMID: 30410690 PMC: 6206417. DOI: 10.5001/omj.2018.89.

The role of laparoscopy in children with groin problems.

Aggarwal H, Kogan B Transl Androl Urol. 2016; 3(4):418-28.

PMID: 26816798 PMC: 4708135. DOI: 10.3978/j.issn.2223-4683.2014.12.11.

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