A Laparoscopic Comparative Study of Right and Left Paraduodenal Herniae : A Tale of Two Cities

Abstract

It was the best of times, it was the worst of times…’, thus began Charles Dickens in his classic novel ‘A Tale Of Two Cities’. We revisit right and left Paraduodenal herniae(PDH) in this article. Our ‘two cities’ are the fossae of Waldeyer and Landzert respectively. We think the times are the best as of present day, since cutting edge diagnostic tools(CECT abdomen) offer us an unambiguous diagnosis of PDH. Also the advent of minimal access surgery from the last decade of the twentieth century onwards, has afforded us the luxury of treating PDH by laparoscopy. However these are also the worst of times since PDH, though rare, constitutes 53% of all internal hernias and if undiagnosed, can increase mortality rate upto 20%[1]. In this article, we attempt to make a side by side comparison of right and left PDH vis-à-vis their embryology, diagnosis, laparoscopic ‘first look appearance’, surgical therapy and the endresult.