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ARTICLES:
Antti I. Koivusalo, Reijo Korpela, Kari Wirtavuori, Satu Piiparinen, Risto J. Rintala, and Mikko P. Pakarinen
A Single-Blinded, Randomized Comparison of Laparoscopic Versus Open Hernia Repair in Children
Pediatrics 2009; 123: 332-337 [Abstract] [Full text] [PDF]
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[Read eLetters] Should a contralateral PPV be closed at laparoscopic inguinal hernia repair?
Ori Ron, Luca Giacomello, Simon Eaton, Agostino Pierro   (8 March 2009)

Should a contralateral PPV be closed at laparoscopic inguinal hernia repair? 8 March 2009
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Ori Ron,
Paediatric Surgery Registrar
Great Ormond Street Hospital for Children,
Luca Giacomello, Simon Eaton, Agostino Pierro

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Re: Should a contralateral PPV be closed at laparoscopic inguinal hernia repair?

o.ron{at}ich.ucl.ac.uk Ori Ron, et al.

We very much enjoyed reading the paper by Koivusalo et al [1] in the January 2009 edition of Pediatrics. We welcome such a carefully performed randomised controlled trial in paediatric surgery in an area where an evidence base is lacking. This study was able to shed some light on the natural history of inguinal hernia development in that they noted that 3 out of 9 males (33%) and 0 out of 3 females with an open contralateral patent processus vaginalis (PPV) at laparoscopy went on to form a clinical contralateral metachronous hernia. These data, which are not available anywhere in the literature, are useful for paediatric surgeons when deciding whether or not to close a contralateral PPV at the time of laparoscopic inguinal hernia repair. We would like to ask the authors: i) what were the ages of the patients who were noted to have a contralateral PPV at laparoscopy and subsequently developed a metachronous contralateral inguinal hernia?; ii) have the results of the study lead to a change in their practice and do the authors now perform simultaneous laparoscopic closure of a contralateral PPV at the time of laparoscopic inguinal hernia repair?

[1] Koivusalo AI, Korpela R, Wirtavuori K, Piiparinen S, Rintala RJ, Pakarinen MP. A single-blinded, randomized comparison of laparoscopic versus open hernia repair in children. Pediatrics. 2009 Jan;123(1):332-7

Conflict of Interest:

None declared