WOFAPS 2025 8th World Congress of Pediatric Surgery

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Oral Presentation - 77

Incidence and Significance of Contralateral Patent Processus Vaginalis in Pediatric Patients Undergoing Laparoscopic Hernia Repair: A Prospective Observational Study

ARMAGHAN AHMED AHMED 1, Fiza Ashfaq 2
1 University of lahore Pakistan
2 shaikh zayed Lahore

ABSTRACT

Background: Inguinal hernia is a common pediatric surgical condition. Laparoscopic approaches allow visualization of the contralateral internal ring, potentially identifying an asymptomatic contralateral patent processus vaginalis (PPV), which may progress to contralateral metachronous inguinal hernia (CMIH) if left untreated. However, the benefit of routine prophylactic closure of contralateral PPV remains debated, particularly in resource-constrained settings.

Objective: To determine the frequency of contralateral PPV in children undergoing laparoscopic repair for unilateral inguinal hernia and assess its association with age and gender.

Methods: This prospective observational study was conducted at the Department of Pediatric Surgery from January to December 2023. A total of 148 children aged 1–13 years undergoing laparoscopic percutaneous extraperitoneal closure were enrolled. Demographic data, intraoperative findings, and incidence of contralateral PPV were recorded. Statistical analysis was performed using SPSS v25.0, with chi-square tests used to assess associations between PPV and age or gender. A p-value < 0.05 was considered statistically significant.

Results: Among 148 patients (mean age 5.8 ± 3.2 years; 82.4% male), 80 (54.1%) presented with unilateral hernia. Of these, 14 (17.5%) had an asymptomatic contralateral PPV identified and closed laparoscopically. Age-wise, PPV was most frequent in children ≤2 years (30%), but this trend was not statistically significant (p = 0.325). Similarly, gender-based analysis showed no significant association (male 18.2% vs. female 14.3%; p = 1.000). No major perioperative complications were reported. Conclusion: Nearly one in six children with clinically unilateral hernia harbored an occult contralateral PPV, justifying routine laparoscopic evaluation and simultaneous repair. Age and gender were not predictive of contralateral PPV. Prophylactic closure during primary surgery may prevent future CMIH, avoiding secondary interventions and improving outcomes.


Keywords: Pediatric inguinal hernia, Contralateral patent processus vaginalis, Laparoscopic hernia repair, Metachronous hernia, Percutaneous extraperitoneal closure, Pediatric surgery

Keywords: Pediatric inguinal hernia, Contralateral patent processus vaginalis, Laparoscopic hernia repair, Metachronous hernia, Percutaneous extraperitoneal closure, Pediatric surgery,

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