PMID: 11912440Mar 26, 2002Paper

Laparoscopic variability of the internal inguinal ring: review of anatomical variation in children with and without a patent processus vaginalis

The Journal of Urology
Randy G NixonJohn W Brock

Abstract

Diagnostic laparoscopy is routinely performed at our institution in children with a unilateral inguinal hernia to determine whether the contralateral processus vaginalis is patent. We reviewed the anatomical variability of the inguinal ring at laparoscopy in children with and without a hernia in various age groups. Since 1992, we have performed diagnostic laparoscopy in more than 1,500 children with a known inguinal hernia. Intraoperative imaging was correlated with clinical and operative findings to characterize the anatomical variability of the internal ring. The internal ring had many variations. The photographs presented show evidence of the progression from the flat closed ring to the widely open sac. Clefts and veils of peritoneum sometimes made determining the exact anatomy difficult. Experience shows that the various anatomical variations are associated with different pathological conditions. Characterization of the anatomical variability of the internal ring is essential for determining the patency of the processus vaginalis at diagnostic laparoscopy in children with a known inguinal hernia. We classified these variations in accordance with clinical and surgical findings.

References

Feb 1, 1995·Journal of Pediatric Surgery·P A GrossmannN F Paradise
Aug 1, 1994·Journal of Pediatric Surgery·G W HolcombW M Morgan
Aug 1, 1996·Journal of Pediatric Surgery·G W HolcombJ W Brock
Aug 1, 1996·Journal of Pediatric Surgery·M L WulkanP Vescio
Jul 11, 1998·Journal of Pediatric Surgery·D M MiltenburgM L Brandt

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Citations

May 11, 2010·Pediatric Surgery International·Mairi StevenNicola Brindley
Apr 10, 2008·Surgical Endoscopy·Ramanathan Saranga BharathiVasudevan Baskaran
Dec 20, 2005·Hernia : the Journal of Hernias and Abdominal Wall Surgery·Selami SözübirB Haluk Güvenç
Dec 28, 2012·Hernia : the Journal of Hernias and Abdominal Wall Surgery·S M K ShehataA M Hassan
May 17, 2007·Current Opinion in Pediatrics·Kevin P Mollen, Timothy D Kane
Nov 29, 2014·Hernia : the Journal of Hernias and Abdominal Wall Surgery·Y-C TsaiS-C Chueh

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