The role of laparoscopic evaluation to detect a contralateral defect at initial presentation for inguinal hernia repair.

TitleThe role of laparoscopic evaluation to detect a contralateral defect at initial presentation for inguinal hernia repair.
Publication TypeJournal Article
Year of Publication2011
JournalThe American surgeon
Volume77
Issue11
Pagination1463-6
Date Published2011 Nov
ISSN0003-1348
AbstractOur objective was to determine the accuracy of laparoscopic evaluation to detect a contralateral patent processus vaginalis (CPPV) at initial presentation for inguinal hernia (IH) repair and the rate of CPPV relative to age, sex, and initial hernia side. We performed a 5-year retrospective review of 1580 pediatric patients with unilateral IH in which surgeons selectively used laparoscopy to evaluate for a CPPV. There were 1205 boys and 303 girls; 980 (65%) presented with right IH (RIH) and 528 (35%) with left IH (LIH). Laparoscopic evaluation was performed in 459 (47%) patients presenting with RIH and 225 (43%) patients presenting with LIH. Laparoscopic evaluation was positive for CPPV in 32 per cent of patients with RIH and 42 per cent of patients with LIH (P = 0.0168). CPPV was associated with prematurity (P = 0.0003) and age younger than 6 months (P = 0.0001) but not with sex (P = 0.55). The future contralateral occurrence rate was 1.6 per cent and recurrence rate 0.2 per cent. This study supports the accuracy of CPPV evaluation by laparoscopy. Although the rate of CPPV decreases after 6 months of age, girls older than 2 years of age have a significantly higher rate of CPPV than boys, supporting laparoscopic evaluation in older girls.
URLhttps://www.ingentaconnect.com/openurl?genre=article&issn=0003-1348&volume=77&issue=11&spage=1463&aulast=Draus%20JM
PubMed Linkhttp://www.ncbi.nlm.nih.gov/pubmed/22196658?dopt=Abstract
Short TitleAm Surg