Laparoscopic repair on asymptomatic contralateral patent processus vaginalis in children with unilateral inguinal hernia: A centre experience and review of the literature

Purpose: We investigate the prevalence of contralateral patent processus vaginalis (CPPV) in children presenting with symptomatic unilateral inguinal hernia under diagnostic laparoscopy and its implication on contralateral surgery. Methods: Over a 24‐month period, 79 children (66 boys, 13 girls) aged 1 month to 8 years with symptomatic unilateral inguinal hernia underwent laparoscopic hernia repair. Twenty‐nine patients (36.7%) were under 24 months of age and 45 (57.0%) presented with right inguinal hernia. The contralateral internal inguinal ring was evaluated for CPPV. Bilateral repairs were carried out if CPPV was present. Results: The overall prevalence of asymptomatic CPPV was 39.2% in children who presented with unilateral inguinal hernia. The prevalence of asymptomatic CPPV was 48.3% for children aged under 24 months old and 26.0% in children above 24 months old (P = 0.044). CPPV was present in 52.9% of left‐side hernia under laparoscopy and in 28.9% of right‐side hernia (P = 0.030). Conclusion: The prevalence of asymptomatic CPPV under laparoscopy is nearly twice the reported incidence of symptomatic contralateral hernia development after conventional unilateral herniotomy. Further studies on the natural history of CPPV are necessary to determine the indications for repair of asymptomatic CPPV.