The role of contralateral exploration in pediateric unilateral inguinal hernia repair remains controversial . The purposes 
of this study were : firstly to evaluate the laparoscopic contralateral groin to acertain the incidence of contralateral patent
processus vaginalis through the ipsilateral hernial sac at herniorraphy . 
Secondly , evaluation of objective reliable method for selective herniotomy (PPV >2 cm) . 
Laparoscopic evaluation was successful in 65 patients out of 80 patients (81%) . 
The contralateral processus was closed in 34 (52%) patients, patent but covered by peritoneal diaphragm in 14 
 (22%) patients and clearly patent in 17 (26%) patients. Proping of the clearly patent processus vaginalis using the C.V.P. 
guide wire revealed 9 patients with PPV < 2 cm while 8 patients with PPV > 2 cm for those patients selective herniotomy was 
performed . 
The patients were followed up for maximum 2 years without reported hernial recurrences but single patient developed 
contralateral hernia . There was no complications related to insufflation , laparoscopy or C.V.P. guide wire . 
In this study , the sensitivity , specificity and accuracy for laparoscopic detection of PPV were 96.8% , 100 % and 
 98 % respectively .Also , the sensitivity , specificity and accuracy for selective herniotomy using the C.V.P. guide wire 
during laparoscopy were 90% , 100% , 98.4% respectively . 
So, not only laparoscopic evaluation of the contralateral side via involved hernial sac at herniorrphy should be 
considered in all pediatric patients at herniorraphy but also selective herniotomy for cases of PPV > 2cm measured 
objectively .