To explore the occurrence rate of asymptomatic contralateral patent processus vaginalis (ACPPV) in laparoscopic surgery for unilateral inguinal hernia in children, and to discuss the non-surgical indications of ACPPV to provide clinical basis for individualized treatment and avoiding overtreatment.

124 children with unilateral inguinal hernia were selected in Tongzhou district maternal and child health care hospital between January 2019 and December 2019. The contralateral situation was explored during the laparoscopic surgery. For children with ACPPV, if the inner ring ≥4.5 mm under preoperative ultrasonic examination, or the inner ring <4.5 mm while the depth and width of the inner ring >1 cm during the exploration, the percutaneous extraperitoneal closure was performed. If the inner ring <4.5 mm under preoperative ultrasonic examination, the depth and width of the inner ring <1 cm during the exploration, and the patients had no positive family history, no treatment was required. Operation time, complications and occurrence of MCH within 1 year after operation were compared.

(1) The incidence of ACPPV was 56.5% and there was no statistical difference of ACPPV occurring in left and right side (P>0.05). (2) The average operation time of bilateral closure group was (39.2±6.5) minutes, and that of single closure group was (27.2±4.6) minutes, the difference was statistically significant (P<0.05). The intraoperative blood loss in the bilateral operation group was 2.9±1.28 mL, and that in the single closure group was (2.1±0.43) ml, with statistical difference (P<0.05). There were 16 cases of postoperative inguinal and scrotal edema in children with bilateral surgery, and there was no obvious edema in the contralateral non-treatment group after surgery, with significant statistical difference (P<0.05). (3) After 1 year follow-up, MCH occurred in 1 case without ACPPV, and no recurrence and MCH occurred in ACPPV children.

The occurrence rate of ACPPV was high in unilateral inguinal hernia of children. When the inner ring <4.5 mm under ultrasound examination, and the depth and width of the inner ring <1 cm in the operation, without family history, it could be used as a clinical reference for non-surgical treatment of ACPPV.