Objective: To report a pediatric case of unilateral recurrent inguinal hernia after open repair, with an occult contralateral lesion detected and treated during the same laparoscopic procedure.
Case presentation: A 5.5-year-old boy (32 kg) had undergone open repair of a left inguinal hernia 18 months earlier. He was admitted with a prominent left inguinoscrotal bulge, while the right groin remained asymptomatic. Surgery was indicated based on clinical findings and a planned diagnostic–therapeutic laparoscopy. Laparoscopic exploration confirmed recurrent left inguinal hernia and revealed a patent right internal ring consistent with an occult contralateral hernia. Bilateral laparoscopic-assisted extraperitoneal internal ring closure was performed using hydrodissection and double stitches with 3-0 Prolene via two trocars placed through a single umbilical incision. Operative time was 45 minutes. The postoperative course was uneventful, and the patient was discharged the same day under a day-surgery pathway. At 8-month follow-up (March 2026), no recurrence was observed.
Conclusion: This case suggests that laparoscopy may be a useful option in selected cases of recurrent inguinal hernia, particularly when contralateral evaluation is required, and is consistent with the trend toward minimally invasive and day-surgery management.