Incidental Inguinal Hernias on Laparoscopy

Abstract

Laparoscopic examination of the contralateral inguinal ring has been advocated to exclude contralateral hernia in young children. We used the size of the open internal ring and the depth of the patent processus vaginalis as a parameter to decide whether laparoscopic herniotomy was indicated. Methods: Records of all laparoscopic procedures in children performed in a large tertiary care hospital over a 2.5-year period were retrospectively analysed. Results: Laparoscopy in 346 children revealed the presence of an incidental asymptomatic patent processus vaginalis in 47 cases. Of these, 38 were present as a contralateral hernia among 171 laparoscopies for inguinal hernias. Conclusion: The presence of an incidentally detected, asymptomatic but significant-sized open internal ring is not uncommon. The authors recommend that a 1-cm diameter and a 2-cm depth of open internal ring be taken as a significant indication for herniotomy. The authors also emphasize that a reported incidence of contralateral patent processus vaginalis of up to 56.2% justifies the procedure of laparoscopic herniotomy in all children.

Keywords

• contralateral patent processus vaginalis
• incidental
• inguinal hernia
• laparoscopy