LAPAROSCOPIC EVALUATION OF THE CONTRALATERAL ASYMPTOMATIC GRION IN PRE-SCHOOL CHILDREN WITH SELECTIVE HERNIOTOMY | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 20, Issue 2, April 2001, Page 555-560 PDF (526.83 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2001.376382 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Saleh El-Awady* ; Hesham Sharaf El-Din; Khaled Kandeel | ||||
| Department of General Surgery , Faculty of Medicine Mansoura University, Egypt . | ||||
| Abstract | ||||
| The role of contralateral exploration in pediateric unilateral inguinal hernia repair remains controversial . The purposes of this study were : firstly to evaluate the laparoscopic contralateral groin to acertain the incidence of contralateral patent processus vaginalis through the ipsilateral hernial sac at herniorraphy . Secondly , evaluation of objective reliable method for selective herniotomy (PPV >2 cm) . Laparoscopic evaluation was successful in 65 patients out of 80 patients (81%) . The contralateral processus was closed in 34 (52%) patients, patent but covered by peritoneal diaphragm in 14 (22%) patients and clearly patent in 17 (26%) patients. Proping of the clearly patent processus vaginalis using the C.V.P. guide wire revealed 9 patients with PPV < 2 cm while 8 patients with PPV > 2 cm for those patients selective herniotomy was performed . The patients were followed up for maximum 2 years without reported hernial recurrences but single patient developed contralateral hernia . There was no complications related to insufflation , laparoscopy or C.V.P. guide wire . In this study , the sensitivity , specificity and accuracy for laparoscopic detection of PPV were 96.8% , 100 % and 98 % respectively .Also , the sensitivity , specificity and accuracy for selective herniotomy using the C.V.P. guide wire during laparoscopy were 90% , 100% , 98.4% respectively . So, not only laparoscopic evaluation of the contralateral side via involved hernial sac at herniorrphy should be considered in all pediatric patients at herniorraphy but also selective herniotomy for cases of PPV > 2cm measured objectively . | ||||
| Keywords | ||||
| hernia; laparoscopy; processus vaginalis | ||||
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