Unexpected Metachronous Hernia Development in Children Following Laparoscopic Unilateral Hernia Repair with Negative Evaluation for Contralateral Patent Processus Vaginalis

2013 ◽  
Vol 23 (3) ◽  
pp. 287-290 ◽  
Author(s):  
Yuk Him Tam ◽  
Yuen Shan Wong ◽  
Kristine Kit Yi Pang ◽  
Siu Yan Tsui ◽  
Jennifer Wai Cheung Mou ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Negative Evaluation ◽  
Processus Vaginalis ◽  
Patent Processus Vaginalis ◽  
Metachronous Hernia ◽  
Contralateral Patent Processus Vaginalis

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

2011 ◽  
Vol 77 (11) ◽  
pp. 1463-1466 ◽  
Author(s):  
John M. Draus ◽  
Sarah Kamel ◽  
Aaron Seims ◽  
Frederick J. Rescorla
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Pediatric Patients ◽  
Initial Presentation ◽  
Occurrence Rate ◽  
Processus Vaginalis ◽  
Patent Processus Vaginalis ◽  
Contralateral Patent Processus Vaginalis ◽  
Laparoscopic Evaluation

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.

scholarly journals Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

2020 ◽  
Author(s):  
Jia You ◽  
Gang Li ◽  
Shuang Li ◽  
Haitao Chen ◽  
Jun Wang
Keyword(s):  
Inguinal Hernia ◽  
Doppler Ultrasound ◽  
Vas Deferens ◽  
Abdominal Cavity ◽  
Undescended Testes ◽  
Processus Vaginalis ◽  
Hernia Sac ◽  
Patent Processus Vaginalis ◽  
Contralateral Patent Processus Vaginalis ◽  
Laparoscopic Orchiopexy

Abstract Background Discuss the superiority of laparoscopic orchiopexy in the treatment of inguinal palpable undescended testes. Methods Inclusion criteria: Preoperative examination and color Doppler ultrasound examination confirmed that the testes were located in the inguinal canal and could not be pulled into the scrotum, except for retractive and ectopic testes. The surgical steps were depicted as follow. The retroperitoneal wall was carved by ultrasonic scalpels, separates the spermatic vessels closed to the inferior pole of the kidney if necessary, dissects the peritoneum of vas deferens, cuts the testicular gubernaculum, and pulls back the testicle into the abdominal cavity. Besides, protect the vas deferens, and descend the testes to the scrotum and fix them without tension. Results There were 773 patients with 869 inguinal undescended palpable testes, 218 cases on the left side, 459 cases on the right side and 96 cases with bilateral undescended testes, whose age ranged from 6 months to 8 years, with an average of 20 months. All testes were successfully operated, no converted to open surgery. The average operation time was (34.8 ± 5.4) min. There were 692 testes have an ipsilateral patent processus vaginalis (89.5%); In 677 cases of unilateral cryptorchidism, 233 cases (34.4%) have a contralateral patent processus vaginalis, and laparoscopic percutaneous extraperitoneal closure the hernia sac carry out during the surgery. There was no subcutaneous emphysema during the operation, no vomiting, no abdominal distension, no wound bleeding and obvious pain after surgery, especially wound infection is rarely. Doppler ultrasound was evaluated regularly after surgery. The patients were followed up for 6 to 18 months. All the testes were located in the scrotum without testicular retraction and atrophy. No inguinal hernia or hydrocele was found in follow-up examination. Conclusion Laparoscopic orchiopexy manage inguinal palpable cryptorchidism is safe and effective, and there are obvious minimally invasive advantages. Furthermore, It could discover a contralateral patent processus vaginalis, and treat at the same time, which avoid the occurrence of metachronous inguinal hernia.

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