Inguinal hernia: what we have learned from laparoscopic evaluation of the contralateral side
- PMID: 17505198
- DOI: 10.1097/MOP.0b013e3281574597
Inguinal hernia: what we have learned from laparoscopic evaluation of the contralateral side
Abstract
Purpose of review: The evaluation for and management of a contralateral patent processus vaginalis in children presenting with a unilateral inguinal hernia has been debated for over 60 years. The emergence of transinguinal laparoscopy as an evaluative tool has changed the landscape of the debate, offering a safe and minimally invasive option. The review will highlight some of the significant recent contributions to this debate.
Recent findings: Recent studies have confirmed the safety of transinguinal laparoscopy, and demonstrated a high level of sensitivity and specificity for it in the evaluation of the contralateral inguinal ring. In comparison, the practice of physical examination under anesthesia for evaluation of the contralateral inguinal region has proven to be ineffective. Further, age and gender differences in the incidence of contralateral patent processus vaginalis have recently been challenged. These data call into question the practices of routine or selective open inguinal exploration and present laparoscopy as the most effective means of evaluation.
Summary: Transinguinal laparoscopy offers a safe and effective means of evaluating the contralateral inguinal ring during ipsilateral hernia repair. The relatively high incidences of both contralateral patent processus vaginalis and contralateral metachronous hernia development in children justify the use of routine laparoscopic evaluation.
Similar articles
-
The contribution of intraoperative transinguinal laparoscopic examination of the contralateral side to the repair of inguinal hernias in children.World J Pediatr. 2010 May;6(2):119-24. doi: 10.1007/s12519-010-0027-0. Epub 2010 May 21. World J Pediatr. 2010. PMID: 20490767 Review.
-
Transinguinal laparoscopic examination: an end to the controversy on repair of inguinal hernia in children.Isr Med Assoc J. 2004 Jun;6(6):339-41. Isr Med Assoc J. 2004. PMID: 15214460 Clinical Trial.
-
Transinguinal laparoscopic exploration for identification of contralateral inguinal hernias in pediatric patients.J Pediatr Surg. 2011 Dec;46(12):2349-52. doi: 10.1016/j.jpedsurg.2011.09.027. J Pediatr Surg. 2011. PMID: 22152880
-
Selective laparoscopic probing for a contralateral patent processus vaginalis reduces the need for contralateral exploration in inconclusive cases.J Pediatr Surg. 2000 Aug;35(8):1151-4. doi: 10.1053/jpsu.2000.8714. J Pediatr Surg. 2000. PMID: 10945684
-
Ten-year review of groin laparoscopy in 1001 pediatric patients with clinical unilateral inguinal hernia: an improved technique with transhernia multiple-channel scope.J Pediatr Surg. 2011 May;46(5):1011-4. doi: 10.1016/j.jpedsurg.2010.12.020. J Pediatr Surg. 2011. PMID: 21616272 Review.
Cited by
-
Inguinal hernia repair by Bianchi incision in boys: a retrospective study.Pediatr Surg Int. 2018 Mar;34(3):289-295. doi: 10.1007/s00383-017-4217-x. Epub 2017 Nov 29. Pediatr Surg Int. 2018. PMID: 29188379
-
Systematic review for paediatric metachronous contralateral inguinal hernia: a decreasing concern.Pediatr Surg Int. 2011 Sep;27(9):953-61. doi: 10.1007/s00383-011-2919-z. Epub 2011 May 21. Pediatr Surg Int. 2011. PMID: 21604078 Review.
-
Modified 2-port laparoscopic herniorrhaphy with Kirschner wire in children: A retrospective review.Medicine (Baltimore). 2018 Oct;97(42):e12790. doi: 10.1097/MD.0000000000012790. Medicine (Baltimore). 2018. PMID: 30334970 Free PMC article.
-
The contribution of intraoperative transinguinal laparoscopic examination of the contralateral side to the repair of inguinal hernias in children.World J Pediatr. 2010 May;6(2):119-24. doi: 10.1007/s12519-010-0027-0. Epub 2010 May 21. World J Pediatr. 2010. PMID: 20490767 Review.
-
Independent risk factors for contralateral patent processus vaginalis undetected by pre-operative ultrasonography in boys with unilateral inguinal hernia.Pediatr Surg Int. 2019 May;35(5):591-595. doi: 10.1007/s00383-019-04444-x. Epub 2019 Feb 7. Pediatr Surg Int. 2019. PMID: 30729303
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Research Materials
Miscellaneous
