THE OTHER SIDE OF PEDIATRIC HERNIAS - THE ROLE OF LAPAROSCOPY

The role of contralateral inguinal exploration in neonates, infants, a nd children presenting with unilateral hernias is controversial. Facto rs considered by surgeons include the patient's age, sex, and side of the clinically apparent hernia. The purpose of this study was to evalu ate the role of diagnostic laparoscopy performed through the clinicall y apparent hernia sac to identify a contralateral patent processus vag inalis (CPPV) in children and limit contralateral exploration to CPPV- positive patients. One hundred neonates, infants, and children underwe nt laparoscopic evaluation for a CPPV through the ipsilateral hernia s ac. There were 79 boys and 21 girls. Forty-eight of 100 (48%) had a CP PV identified, which was confirmed operatively. Thirty-one of 68 patie nts (46%) with a right-sided and 18 of 32 (56%) with a left-sided hern ias had a CPPV (P = 0.39). Thirty-six of 56 (64%) patients younger tha n 6 months of age had a CPPV compared to 13 of 44 (30%) older than six months (P = 0.001). Fourteen of 21 (67%) girls had a CPPV compared to 35 of 79 (44%) boys (P = 0.087). Laparoscopy through the hernia sac i s a safe and effective means of identifying the presence of a CPPV and avoiding unnecessary contralateral inguinal exploration. Infants (<6 months) are much more likely to have a CPPV.