Diagnostic Laparoscopic Evaluation of the Contralateral Internal Inguinal Ring: The Search for a Prospective Hernia

The exact etiology of metachronous hernia is unclear. Does a contralateral patent processus vaginalis proceed to form a hernia sac, or does the contralateral side have a silent hernia, present from birth? Diagnostic laparoscopic evaluation for a potential contralateral hernia is a simple, accurate, fast, and effective way to reduce negative explorations. It is easily learned and requires less time than routine bilateral exploration. Despite these benefits, there remains the risk of iatrogenic injury in a situation that might never lead to a clinical hernia. The question of how to determine when the anatomy of the processus vaginalis foretells a future hernia is explored.