Flexible transinguinal laparoscopy to assess the contralateral ring in pediatric inguinal hernias

Christian Pavlovich, G. A. Gmyrek, T. A. Gardner, D. P. Poppas, D. T. Mininberg

Research output: Contribution to journalArticle

Abstract

The incidence of contralateral patent processus vaginalis (CPPV) is >50% in infants with clinical unilateral inguinal hernia (CUIH) and decreases only slowly with advancing age. Laparoscopy through the hernia sac (transinguinal laparoscopy) to detect suspected CPPV is a safe and efficient way to minimize routine contralateral inguinal exploration, but can be technically difficult. We used flexible urologic instruments and/or angled cystoscopic lenses to make transinguinal laparoscopy easier. Over a 3-year period, 37 patients (34 boys and 3 girls) ranging in age from 4 months to 12 years (mean age 59 months) with CUIH underwent ipsilateral groin exploration and diagnostic transinguinal laparoscopy. Laparoscopy was performed with flexible 17F cystoscopes (26 cases), flexible 9F ureteroscopes (2 cases), and rigid 70°cystoscope lenses (9 cases). We detected eight CPPV (22%) in our series of 20 right and 17 left inguinal hernias, in a mean transinguinal laparoscopy time of 4.5 minutes. At 26-month mean follow-up, no patient whose contralateral inguinal ring was deemed closed had developed a hernia. Flexible fiberoptic urologic scopes and/or angled cystoscope lenses make transinguinal laparoscopy easy and efficacious in the pediatric population. Our series represents the longest longitudinal study of transinguinal taparoscopy for the diagnosis of CPPV.

Original languageEnglish (US)
Pages (from-to)141-144
Number of pages4
JournalTechniques in Urology
Volume4
Issue number3
Publication statusPublished - 1998
Externally publishedYes

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Keywords

  • Inguinal hernia
  • Laparoscopy
  • Pediatric hernia
  • Processus vaginalis

ASJC Scopus subject areas

  • Urology

Cite this

Pavlovich, C., Gmyrek, G. A., Gardner, T. A., Poppas, D. P., & Mininberg, D. T. (1998). Flexible transinguinal laparoscopy to assess the contralateral ring in pediatric inguinal hernias. Techniques in Urology, 4(3), 141-144.