Benefits of contralateral patent processus vaginalis closure during laparoscopic surgery for inguinal hernia in female children
Journal
Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)
Date Issued
2022-06
Author(s)
Abstract
After more than a decade, an accurate description of the current state of pediatric inguinal hernia repair
still an issue of contention. Improvement of techniques together with patient-entered intervention that
account for the experiences related to individual disease characteristics have become an important factor
of which the surgeon must be aware. Therefore, the aim of this study is to analyze a potential treatment for
metachronous contralateral inguinal hernia (MCIH) in children during laparoscopic assisted percutaneous
internal inguinal ring suturing (PIRS). In a prospective clinical study, carried out at the University Clinic
for Pediatric Surgery in Skopje, Republic of North Macedonia, we analyzed the data from 49 female
children, aged 1-14 years old, with clinically diagnosed congenital inguinal hernia treated via PIRS. The
position of hernias on the right side was 29 (59.2%) on the left side was 19 (38.8%) and on both sides was
1 (2.0%). With intraoperative assessment, it was determined that in 33 (67.3%) participants there was no
presence of a hidden hernia, while in 16 (32.7%), there was indeed the presence of a hidden hernia. Of the
hidden hernias determined laparoscopically [16 (100%)], 8 (50%) were left and right hidden hernias, all
treated laparoscopically. The PIRS technique is a procedure where the basic advanced treatment is exploration. This also included the adequate treatment of other pathologies, such as the prophylactic closure of
a contralateral patent processus vaginalis with simultaneous treatment as there is the potential for hernia
in future, therefore reducing the number of metachronous inguinal hernias.
still an issue of contention. Improvement of techniques together with patient-entered intervention that
account for the experiences related to individual disease characteristics have become an important factor
of which the surgeon must be aware. Therefore, the aim of this study is to analyze a potential treatment for
metachronous contralateral inguinal hernia (MCIH) in children during laparoscopic assisted percutaneous
internal inguinal ring suturing (PIRS). In a prospective clinical study, carried out at the University Clinic
for Pediatric Surgery in Skopje, Republic of North Macedonia, we analyzed the data from 49 female
children, aged 1-14 years old, with clinically diagnosed congenital inguinal hernia treated via PIRS. The
position of hernias on the right side was 29 (59.2%) on the left side was 19 (38.8%) and on both sides was
1 (2.0%). With intraoperative assessment, it was determined that in 33 (67.3%) participants there was no
presence of a hidden hernia, while in 16 (32.7%), there was indeed the presence of a hidden hernia. Of the
hidden hernias determined laparoscopically [16 (100%)], 8 (50%) were left and right hidden hernias, all
treated laparoscopically. The PIRS technique is a procedure where the basic advanced treatment is exploration. This also included the adequate treatment of other pathologies, such as the prophylactic closure of
a contralateral patent processus vaginalis with simultaneous treatment as there is the potential for hernia
in future, therefore reducing the number of metachronous inguinal hernias.
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