Laparoscopic evaluation for a contralateral patent processus vaginalis.

Between May 1, 1992 and March 1, 1993, 221 consecutively treated children under 10 years of age evaluated by the authors for a known inguinal hernia were involved in a prospective protocol to determine whether diagnostic laparoscopy has a place for evaluation of the contralateral inguinal region. Twenty-six had known bilateral inguinal hernias and did not require diagnostic laparoscopy. Of the other 195 children who underwent laparoscopy before hernia repair, 86 had a unilateral hernia with a contralateral patent processus vaginalis (CPPV), and 109 had only a unilateral hernia. After anesthesia, it was suspected on prelaparoscopic clinical examination that 55 patients had a CPPV. During laparoscopy, it was noted that 31 (56%) had patent processus vaginalis and 24 (44%) did not. Of the 140 patients believed to have a CPPV on prelaparoscopic clinical examination, 60 (43%) did and 80 (57%) did not. Insufflation alone was not diagnostic of CPPV; of the 195 patients undergoing laparoscopy, insufflation resulted in a positive finding on the known side in only 129 (66%) and on the contralateral side in 23 of the 86 patients (27%) found to have a CPPV. There were no complications related to the laparoscopy or the hernia repair.