Objective:

Inguinal hernia is one of the most common dissease in childhood. Laparoscopic procedures in children are getting more popular common and in some cases surgeons find patent processus vaginalis during operation. Other than inguinal pathologies there is no concensus whether to close the patent processus vaginalis (PPV) or not. As generally accepted, increased intraabdominal pressure may cause clinical hernia in these cases. Therefore the answer of the question above ought to be whether any increased intraabdominal pressure in laparoscopic procedures can transforme these PPV into clinical hernia.

Methods:

Between April 2009 and December 2010 the medical records of all paediatric patients whom treated laparoscopically for apandicitis were reviewed retrospectively. All cases with PPV have been followed-up in case of developing clinical hernia with telephone interviews or clinical evaluation.

Results:

Of 101 patients, 84 cases have been inspected for internal inguinal ring opening. In total, the rate of internal opening was found 20.23% ( 17 cases). Nine were right, 3 were left and 5 were bilateral. 17 cases (ten boys and seven girls) with PPV were followed up average 10.58 months ( Range 2-16 months). Only one girl (5,88%) developed a left inguinal hernia in post operative sixth month. In this case an unnoticed sliding adnexia could be possible the reason of the hernia. None of the other patients had any hernia subsequently.

Conclusions:

Short interval of increased intraabdominal pressure in laparoscopic procedures does not carry a risk of developing clinical hernia therefore any PPV found during laparoscopic procedures need not to be closed.

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