caa a22 4500 475781619 CHVBK 20180406123646.0 cr unu---uuuuu 170329e20000201xx s 000 0 eng 10.1007/s004649900078 doi (NATIONALLICENCE)springer-10.1007/s004649900078 A new technique for laparoscopic exploration to find contralateral patent processus vaginalis [Elektronische Daten] [E. Owings, K. Georgeson] Background: Contralateral inguinal exploration in an infant with a symptomatic unilateral hernia is controversial. A patent processus vaginalis (PPV) may be found in up to 60% of term infants, and even in a greater number of preterm infants. However, only 10% to 30% of children will subsequently develop a contralateral hernia when only the symptomatic side is repaired. Standard contralateral laparoscopic inguinal exploration (CLIE) usually is performed through the ipsilateral groin with an angled scope or through the umbilicus with a 0° scope. A significant number of children have a peritoneal veil shrouding the internal ring. To enhance the accuracy of contralateral groin exploration, we have used a laparoscopic technique of directly visualizing the internal ring through a lateral abdominal approach. Methods: From January 1993 through June 1997, we performed 141 CLIE on infants younger than 1 year of age with symptomatic unilateral inguinal hernia. After routine dissection on the symptomatic side, the sac was used to insufflate the abdominal cavity. A needle catheter was inserted on the contralateral abdominal wall and used to introduce a 1.2-mm scope. If a PPV was identified, the potential hernia was repaired using standard techniques. Results: Of the 141 CLIEs performed on patients younger than 1 year of age, 39 (27.6%) were positive. There were no false-positives. In all, 42 CLIEs (29.7%) were performed on infants born at less than 36 weeks gestation, and 14 of these infants (33.3%) had a positive exploration. The patients were followed for 3 to 57 months. No complications resulted from the technique. One patient had a recurrence on the repaired side. No patients who had a negative CLIE subsequently developed a contralateral hernia. Conclusions: The lateral abdominal approach for laparoscopic evaluation of the contralateral groin is safe and accurate, requiring no additional incisions. Longer follow-up is necessary to determine the true false-negative rate. Springer-Verlag New York Inc., 2000 Key words: Contralateral — Hernia — Exploration — Processus vaginalis nationallicence Owings E. University of Alabama School of Medicine, Children's Hospital of Alabama, 1600 Seventh Avenue South, ACC 300 Birmingham, AL 35233, USA, USA aut Georgeson K. University of Alabama School of Medicine, Children's Hospital of Alabama, 1600 Seventh Avenue South, ACC 300 Birmingham, AL 35233, USA, USA aut Surgical Endoscopy Springer-Verlag 14/2(2000-02-01), 114-116 0930-2794 14:2<114 2000 14 464 https://doi.org/10.1007/s004649900078 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004649900078 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Owings E. University of Alabama School of Medicine, Children's Hospital of Alabama, 1600 Seventh Avenue South, ACC 300 Birmingham, AL 35233, USA, USA aut NATIONALLICENCE 700 1- Georgeson K. University of Alabama School of Medicine, Children's Hospital of Alabama, 1600 Seventh Avenue South, ACC 300 Birmingham, AL 35233, USA, USA aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/2(2000-02-01), 114-116 0930-2794 14:2<114 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer