Transinguinal diagnostic laparoscopy in pediatric inguinal hernia.

The decision of the surgeon whether to explore the opposite groin in a child with an inguinal hernia remains controversial. Numerous techniques have been used to determine the need for contralateral repair. Two groups of patients underwent transinguinal diagnostic laparoscopy at the time of herniorrhaphy to assess the contralateral groin. Of 20 patients older than 24 months, only 1 (5%) was found to have a patent processus vaginalis. In a group of 21 patients ranging from 2 to 24 months, 9 (42.9%) were found to have a contralateral patent processus vaginalis. Twelve patients had a closed or slit-like peritoneum at the internal ring. Transinguinal diagnostic laparoscopy can be used to identify which children may benefit from contralateral exploration, as well as those in whom surgery can be avoided.