Transperitoneal Detection of Occult Inguinal Hernia

Kramer, Scott G.; Davis, Scott E.

doi:10.1093/milmed/132.7.512

Cited by 15 publications

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“…The use of a Bakes dilator has been reported; however, this technique has proven unreliable in some reports. 5,8 Herniography has been performed, but this technique has been generally abandoned because of the painful injection and the associated radiation exposure. 9 Diagnostic pneumoperitoneum has also been used, although this is not a reliable technique.…”

Section: Discussionmentioning

confidence: 99%

“…The options include: never exploring the opposite side; selectively exploring the contralateral side based on age, sex, or initial side; or attempting to determine the patency of the contralateral processus vaginalis at the time of the symptomatic hernia repair. Methods used have included the ''silk glove sign,'' which involves palpating the processus vaginalis over the pubic tubercle 3 ; ultrasound 4 ; use of a Bakes dilator through the open hernia sac 5 ; intraoperative diagnostic pneumoperitoneum 6 ; or laparoscopic evaluation through the hernia sac on the symptomatic side. 7 The purpose of this study is to retrospectively review all pediatric patients with the diagnosis of a unilateral inguinal hernia over a 5½-year period and to assess the results of laparoscopic evaluation for a CPPV by using the symptomatic hernia sac to access the peritoneal cavity.…”

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The Role of Laparoscopic Evaluation to Detect a Contralateral Defect at Initial Presentation for Inguinal Hernia Repair

Draus

Kamel

Seims

et al. 2011

The American Surgeon™

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Our 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 laparoscope 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.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Role of Laparoscopic Evaluation to Detect a Contralateral Defect at Initial Presentation for Inguinal Hernia Repair

Draus

Kamel

Seims

et al. 2011

The American Surgeon™

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Unilateral Inguinal Hernias in Children

Kiesewetter¹

1980

Arch Surg

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Intraoperative laparoscopic diagnosis of contralateral patent processus vaginalis in children with unilateral inguinal hernia

Liu

Chin

Jan

et al. 1995

Journal of British Surgery

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The contralateral internal ring of 96 children was examined laparoscopically during unilateral hernia repair to minimize the chance of development of contralateral hernia. Laparoscopy was performed through the hernia sac before ligation. Of 29 patients with positive laparoscopic findings, 28 had a patient processus vaginalis as confirmed by simultaneous contralateral exploration and there was one false positive. Patency of the contralateral processus vaginalis was found in 28 (29 per cent) of the 96 patients. Children under 2 years of age had a significantly higher incidence of patent contralateral processus vaginalis than older patients. The only complication of the procedure was wound infection in two patients. This is a simple, safe and accurate procedure to select children for contralateral surgical exploration.

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Transperitoneal Detection of Occult Inguinal Hernia

Cited by 15 publications

References 0 publications

The Role of Laparoscopic Evaluation to Detect a Contralateral Defect at Initial Presentation for Inguinal Hernia Repair

The Role of Laparoscopic Evaluation to Detect a Contralateral Defect at Initial Presentation for Inguinal Hernia Repair

Unilateral Inguinal Hernias in Children

Intraoperative laparoscopic diagnosis of contralateral patent processus vaginalis in children with unilateral inguinal hernia

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