J Minim Invasive Surg 1999; 2(2): 27-32

Published online November 26, 1999

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

소아에서 서혜부 탈장수술 중 복강경을 이용한 반대편 탈장 진단

김현진, 정소환, 박영규, 양현승, 김영복, 서해현

서남대학교 의과대학 외과학교실

Laparoscopic Diagnosis of Contralateral Patent Processus Vaginalis in Children with Clinically Unilateral Inguinal Hernia

Yun Jin Kim, M.D., So Hwan Chung, M.D., Young Kyu Park, M.D., Young Bok Kim, M.D., Hae Hyeon Suh, M.D.

Department of Surgery, College of Medicine, Seonam University, Kwangju, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In inguinal hernia of children, detection of process vaginalis in the contralateral side is important to prevent another anesthesia and operation. After elective exploration of the contralateral groin 40 years ago, routine exploration, selective exploration, pneumoperitoneum, and hermiography have been reported. But these methods are not widely accepted because of a risk of cord injury and discomfort. Laparoscopic evaluation of contralateral side can avoid the risk of injury of spermatic cord theoretically. Traditional laparoscopy through an periumbilical incision, has its own morbidity of visceral and vascular injury during a puncture of Veress needle and an insertion of sharp trocar. We passed a cannula and a laparoscope into the peritoneal cavity through the hernia sac.

we used this technique in 10 patients and successfully visualized the internal inguinal region in all cases. Among them, 4 patients (2 boys and 2 girls) revealed patent processus vaginalis in the contralateral side. The positive criteria of diagnostic laparoscopy were: (1) no identifiable termination to the peritoneal sac; (2) bubble could be expressed by palpation; and (3) covering peritoneal veil could be raised with traction of cord to expose th eopening. When the patent parocessus vaginalis were diagnosed, we underwent high ligation of contralateral side in the same time. The mean duration for the laparoscopic examination was 7.2 minutes (ranged 5 to 10 minutes). There was no mortality nor morbidity related to the examination.

This technique was rapid, safe, comfortable, and did not require abdominal wall puncture or an additional incision to identify the patent processus vaginals of contralateral side in the clinically unilateral inhuinal hernia.

Keywords Inguinal hernia, diagnostic laparoscopy, contralateral, pediatric, patent processus vaginalis

Article

J Minim Invasive Surg 1999; 2(2): 27-32

Published online November 26, 1999

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

소아에서 서혜부 탈장수술 중 복강경을 이용한 반대편 탈장 진단

김현진, 정소환, 박영규, 양현승, 김영복, 서해현

서남대학교 의과대학 외과학교실

Laparoscopic Diagnosis of Contralateral Patent Processus Vaginalis in Children with Clinically Unilateral Inguinal Hernia

Yun Jin Kim, M.D., So Hwan Chung, M.D., Young Kyu Park, M.D., Young Bok Kim, M.D., Hae Hyeon Suh, M.D.

Department of Surgery, College of Medicine, Seonam University, Kwangju, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In inguinal hernia of children, detection of process vaginalis in the contralateral side is important to prevent another anesthesia and operation. After elective exploration of the contralateral groin 40 years ago, routine exploration, selective exploration, pneumoperitoneum, and hermiography have been reported. But these methods are not widely accepted because of a risk of cord injury and discomfort. Laparoscopic evaluation of contralateral side can avoid the risk of injury of spermatic cord theoretically. Traditional laparoscopy through an periumbilical incision, has its own morbidity of visceral and vascular injury during a puncture of Veress needle and an insertion of sharp trocar. We passed a cannula and a laparoscope into the peritoneal cavity through the hernia sac.

we used this technique in 10 patients and successfully visualized the internal inguinal region in all cases. Among them, 4 patients (2 boys and 2 girls) revealed patent processus vaginalis in the contralateral side. The positive criteria of diagnostic laparoscopy were: (1) no identifiable termination to the peritoneal sac; (2) bubble could be expressed by palpation; and (3) covering peritoneal veil could be raised with traction of cord to expose th eopening. When the patent parocessus vaginalis were diagnosed, we underwent high ligation of contralateral side in the same time. The mean duration for the laparoscopic examination was 7.2 minutes (ranged 5 to 10 minutes). There was no mortality nor morbidity related to the examination.

This technique was rapid, safe, comfortable, and did not require abdominal wall puncture or an additional incision to identify the patent processus vaginals of contralateral side in the clinically unilateral inhuinal hernia.

Keywords: Inguinal hernia, diagnostic laparoscopy, contralateral, pediatric, patent processus vaginalis

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