pp 1–5 | Cite as

A study of contralateral persistent processus vaginalis in laparoscopic hernia repair in children

  • I. G. Ho
  • K. Ihn
  • E.-J. Koo
  • J.-T. OhEmail author
Original Article



The introduction of laparoscopy for hernia repair permits intra-abdominal observation of a hernia and contralateral persistent processus vaginalis (CPPV). The current study’s aim was to investigate the diameter of opening of an inguinal hernia and CPPV in patients with unilateral inguinal hernia, and to evaluate their correlation with age.


From September 2012 to August 2017, 569 pediatric patients underwent laparoscopic repair of unilateral inguinal hernia. We retrospectively evaluated the size of the hernia and CPPV by measuring the diameter of opening. Pearson correlation analysis and linear-by-linear association were used in the statistical analysis.


The median age at operation was 32.4 months (range 0.2–219 months). CPPV was observed in 330 patients (58.0%), and its incidence was significantly higher in patients with left inguinal hernias than in those with right inguinal hernias (62.8 versus 54.0%, p < 0.001). The mean diameter of opening for the hernias was significantly larger than that for CPPV (11.2 ± 3.1 vs. 6.1 ± 2.5 mm, p < 0.001). The incidence of CPPV gradually decreased from 77.2% in infants to 46.6% in the oldest age group (≥ 6 years) (p trend < 0.001). The diameter of the opening of a hernia was not correlated with increasing age, and the diameter of the opening of a CPPV was not correlated with increasing age, as well.


The diameters of a hernia and CPPV were identified in the current study, and the diameter was not correlated with increasing age. The incidence of CPPV was more common in patients with left inguinal hernias than in those with right inguinal hernias, and it gradually decreased with increasing age.


Inguinal hernia Contralateral persistent processus vaginalis Laparoscopic repair Diameter 



Contralateral persistent processus vaginalis


Laparoscopic repair



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

IGH, KI, EJK, and JTO declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from each patient’s guardian.


  1. 1.
    Kaneda H, Furuya T, Sugito K et al (2015) Preoperative ultrasonographic evaluation of the contralateral patent processus vaginalis at the level of the internal inguinal ring is useful for predicting contralateral inguinal hernias in children: a prospective analysis. Hernia 19(4):595–598. CrossRefGoogle Scholar
  2. 2.
    Kervancioglu R, Bayram MM, Ertaskin I, Ozkur A (2000) Ultrasonographic evaluation of bilateral groins in children with unilateral inguinal hernia. Acta Radiol 41(6):653–657CrossRefGoogle Scholar
  3. 3.
    Kramer SG, Davis SE (1967) Transperitoneal detection of occult inguinal hernia. Mil Med 132(7):512–514CrossRefGoogle Scholar
  4. 4.
    White JJ, Parks LC, Haller JA Jr (1968) The inguinal herniogram: a radiologic aid for accurate diagnosis of inguinal hernia in infants. Surgery 63(6):991–997Google Scholar
  5. 5.
    Liu C, Chin T, Jan SE, Wei C (1995) Intraoperative laparoscopic diagnosis of contralateral patent processus vaginalis in children with unilateral inguinal hernia. Br J Surg 82(1):106–108CrossRefGoogle Scholar
  6. 6.
    Rothenberg RE, Barnett T (1955) Bilateral herniotomy in infants and children. Surgery 37(6):947–950Google Scholar
  7. 7.
    Nixon RG, Pope JCT, Adams MC, Holcomb GW IIIrd, Brock JW IIIrd (2002) Laparoscopic variability of the internal inguinal ring: review of anatomical variation in children with and without a patent processus vaginalis. J Urol 167(4):1818–1820CrossRefGoogle Scholar
  8. 8.
    Esposito C, Escolino M, Cortese G, Aprea G, Turra F, Farina A, Roberti A, Cerulo M, Settimi A (2017) Twenty-year experience with laparoscopic inguinal hernia repair in infants and children: considerations and results on 1833 hernia repairs. Surg Endosc 31(3):1461–1468. CrossRefGoogle Scholar
  9. 9.
    Schier F, Danzer E, Bondartschuk M (2001) Incidence of contralateral patent processus vaginalis in children with inguinal hernia. J Pediatr Surg 36(10):1561–1563. CrossRefGoogle Scholar
  10. 10.
    Draus JM Jr, Kamel S, Seims A, Rescorla FJ (2011) The role of laparoscopic evaluation to detect a contralateral defect at initial presentation for inguinal hernia repair. Am Surg 77(11):1463–1466Google Scholar
  11. 11.
    Toufique Ehsan M, Ng AT, Chung PH, Chan KL, Wong KK, Tam PK (2009) Laparoscopic hernioplasties in children: the implication on contralateral groin exploration for unilateral inguinal hernias. Pediatr Surg Int 25(9):759–762. CrossRefGoogle Scholar
  12. 12.
    Burgmeier C, Dreyhaupt J, Schier F (2014) Comparison of inguinal hernia and asymptomatic patent processus vaginalis in term and preterm infants. J Pediatr Surg 49(9):1416–1418. CrossRefGoogle Scholar
  13. 13.
    Hall NJ, Choi W, Pierro A, Eaton S (2012) Age-related probability of contralateral processus vaginalis patency in children with unilateral inguinal hernia. Pediatr Surg Int 28(11):1085–1088. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatric Surgery, Severance Children’s HospitalYonsei University College of MedicineSeoulRepublic of Korea

Personalised recommendations