Transinguinal laparoscopic examination of the contralateral groin in pediatric herniorrhaphy

Abstract

The authors laparoscopically assessed the contralateral groin (CG) via the symptomatic inguinal hernia in 91 patients to avoid unnecessary CG exploration and to allow for identification of asymptomatic CG hernias. Once the symptomatic hernia sac was opened, a 4.5-mm trocar was placed intraperitoneally and the CG internal ring was inspected with a 4-mm laparoscope. When compared with the authors' previous surgical policy for routine CG exploration in children younger than 2 years of age, laparoscopic findings altered the procedure performed in 42 of 91 patients (46.2%). In patients younger than 2 years of age, the CG did not require repair of an unsuspected hernia in 55.9% of patients based on laparoscopic findings. Conversely, in children 2 years of age or older, 40.4% required CG repairs of unsuspected hernias or patent processus vaginalis (PPV). Transinguinal laparoscopic examination in pediatric herniorrhaphy provides important information about the CG without the need for additional trocar sites.