Unilateral inguinal hernia in girls: Is routine contralateral exploration justified?

Ulman, İbrahim; Demircan, Mehmet; Arikan, Ahmet; Avanoğlu, Ali; Ergün, Orkan; Özok, Geylani; Erdener, Ata

doi:10.1016/0022-3468(95)90452-2

Cited by 30 publications

(17 citation statements)

References 12 publications

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“…In addition to these advantages, we believe that the greatest benefit from this technique is the opportunity to evaluate the contralateral side. The incidence of contralateral hernia after unilateral herniorrhaphy is reported to be 8.8-11.6% [12][13][14]. In our experience, prior to the introduction of laparoscopic herniorrhaphy, contralateral hernia was Fig.…”

Section: Discussionmentioning

confidence: 84%

Laparoscopic percutaneous extraperitoneal closure (LPEC) method for the exploration and treatment of inguinal hernia in girls

et al. 2005

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We recently introduced the laparoscopic percutaneous extraperitoneal closure (LPEC) method for the treatment of girls with inguinal hernia. Using the LPEC method, 129 girls underwent laparoscopic herniorrhaphy. A 5 mm laparoscope was inserted via the umbilicus. A 3 mm "snake retractor" was advanced through the lateral abdominal wall to measure the length of the hernia sac and contralateral patent processus vaginalis (PPV), respectively. The hernia sac and PPV were closed at the level of the internal inguinal ring with a 2-0 non-absorbable purse-string suture using Lapaherclosure, a special 19G needle that can hold a suture at the tip. The length of the hernial sac was significantly longer than that of contralateral PPV (mean 41 mm; range 18-70 mm; P < 0.05). There were no serious complications associated with the procedure. No recurrence of hernia or metachronous contralateral hernia has been identified so far. This approach enables us to perform contralateral exploration without any additional techniques, followed by immediate and accurate closure of the hernia sac and PPV. We conclude that the LPEC method is a safe and efficacious procedure with a low recurrence rate that should be viewed as an acceptable alternative to the traditional open approach.

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Section: Discussionmentioning

confidence: 84%

Laparoscopic percutaneous extraperitoneal closure (LPEC) method for the exploration and treatment of inguinal hernia in girls

et al. 2005

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“…The incidence of metachronous contralateral hernia is thought to be from 3.6% to 10%, much lower than the occurrence of CPPV. 10,11,[13][14][15]23 Thus, a large number of patients with CPPV may not go on to develop clinical hernias. However, because congenital hernias can present at any age, these numbers may underestimate the true incidence of hernias in this population.…”

Section: Discussionmentioning

confidence: 99%

“…8,11,15,16 Traditionally, surgeons that explore selectively base their decision on clinical parameters such as patient age, sex, or side of the hernia. 11 Others have used pneumoperitoneum alone (Goldstein test) to evaluate the contralateral side. 17 In the last 10 years, however, as pediatric laparoscopy has become more commonplace, laparoscopic evaluation of the contralateral side has become more prevalent.…”

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confidence: 99%

“…[3][4][5][6][7][8][9] Opponents argue that the presence of a CPPV is not equivalent to a hernia and that the morbidity and cost of a potentially unnecessary operation is unjustified. 8,[10][11][12][13][14] Children who undergo repairs for unilateral hernias may then undergo routine, selective, or no exploration of the contralateral side. 8,11,15,16 Traditionally, surgeons that explore selectively base their decision on clinical parameters such as patient age, sex, or side of the hernia.…”

mentioning

confidence: 99%

“…8,[10][11][12][13][14] Children who undergo repairs for unilateral hernias may then undergo routine, selective, or no exploration of the contralateral side. 8,11,15,16 Traditionally, surgeons that explore selectively base their decision on clinical parameters such as patient age, sex, or side of the hernia. 11 Others have used pneumoperitoneum alone (Goldstein test) to evaluate the contralateral side.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Is the use of laparoscopy to determine presence of contralateral patent processus vaginalis justified in children greater than 2 years of age?

Bhatia

Gow

Heiss

et al. 2004

Journal of Pediatric Surgery

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Systematic review of the risk of developing a metachronous contralateral inguinal hernia in children

Ron

Eaton

Pierro

2007

British Journal of Surgery

104

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Background: This study aims to establish the risk of developing a metachronous contralateral inguinal hernia (MCIH) following open repair of a unilateral inguinal hernia in children.Methods: A systematic review was performed using a defined search strategy. Studies in which children undergoing open repair of a unilateral inguinal hernia without contralateral exploration and who were followed up for MCIH development were included.Results: Of 5937 titles and abstracts screened, 154 full-text articles were identified for review; 49 papers were analysed with data on 22 846 children. The incidence of MCIH was 7·2 per cent overall, 6·9 per cent in boys and 7·3 per cent in girls (P = 0·381). Children with a left-sided inguinal hernia had a significantly higher risk of developing a MCIH than those with a right-sided hernia (10·2 versus 6·3 per cent respectively; P < 0·001).

show abstract

Unilateral inguinal hernia in girls: Is routine contralateral exploration justified?

Cited by 30 publications

References 12 publications

Laparoscopic percutaneous extraperitoneal closure (LPEC) method for the exploration and treatment of inguinal hernia in girls

Laparoscopic percutaneous extraperitoneal closure (LPEC) method for the exploration and treatment of inguinal hernia in girls

Is the use of laparoscopy to determine presence of contralateral patent processus vaginalis justified in children greater than 2 years of age?

Systematic review of the risk of developing a metachronous contralateral inguinal hernia in children

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