Benefits of Contralateral Patent Processus Vaginalis Closure During Laparoscopic Surgery for Inguinal Hernia in Female Children

Abstract

After more than a decade, an accurate description of the current state of pediatric inguinal hernia repair still an issue of contention. Improvement of techniques together with patient-entered intervention that account for the experiences related to individual disease characteristics have become an important factor of which the surgeon must be aware. Therefore, the aim of this study is to analyze a potential treatment for metachronous contralateral inguinal hernia (MCIH) in children during laparoscopic assisted percutaneous internal inguinal ring suturing (PIRS). In a prospective clinical study, carried out at the University Clinic for Pediatric Surgery in Skopje, Republic of North Macedonia, we analyzed the data from 49 female children, aged 1-14 years old, with clinically diagnosed congenital inguinal hernia treated via PIRS. The position of hernias on the right side was 29 (59.2%) on the left side was 19 (38.8%) and on both sides was 1 (2.0%). With intraoperative assessment, it was determined that in 33 (67.3%) participants there was no presence of a hidden hernia, while in 16 (32.7%), there was indeed the presence of a hidden hernia. Of the hidden hernias determined laparoscopically [16 (100%)], 8 (50%) were left and right hidden hernias, all treated laparoscopically. The PIRS technique is a procedure where the basic advanced treatment is exploration. This also included the adequate treatment of other pathologies, such as the prophylactic closure of a contralateral patent processus vaginalis with simultaneous treatment as there is the potential for hernia in future, therefore reducing the number of metachronous inguinal hernias.

Pediatric incarcerated inguinal hernia: Traditional open or laparoscopic-assisted approach?

“…In contrast, in the control group, 5 patients (22.7%) had postoperative contralateral inguinal hernia, and reoperation was performed after an interval of 3 months. Intraperitoneal treatment of an incarcerated indirect inguinal hernia can be performed laparoscopically without inguinal incision, even a few days after the onset of incarceration of an inguinal hernia; [ 19 , 20 ] neither dissection of the inguinal canal nor excision and closure of the hernia sac via open surgery is necessary. In such cases, laparoscopy over open surgery can be effective in minimizing postoperative complications, such as groin or scrotal hematoma.…”