Abstract
Purpose
This retrospective study aims to evaluate the feasibility, safety and complication rate of laparoscopic inguinal hernia repair for small babies weighing 3 kg or less.
Methods
A retrospective analysis was performed on the surgical charts of 67 infants (47 boys and 20 girls) weighing 3 kg or less who underwent laparoscopic hernia repair in a 3-year period. A regular 5-mm scope was used for visualization, and 2 or 3-mm instruments were used for the closure of the inner inguinal ring using 3/0 non-absorbable suture. The median weight at surgery was 2,600 g (range 1,450–3,000 g). All except three were premature.
Results
Of the 67 infants, 15 (22.3 %) presented with an irreducible hernia. In three cases of irreducible hernias, we also performed a transumbilical appendectomy at the end of the hernia repair. Minor problems related with anesthesia were noted in four cases. Hernia recurrence was observed in three patients (4.4 %). No cases of testicular atrophy occurred. In 10 boys, we observed 12 cases of high testes, only 4 testes requiring subsequent orchiopexy.
Conclusions
Laparoscopic inguinal hernia repair for babies weighing 3 kg or less is feasible, safe and perhaps even less technically demanding than open inguinal herniotomy.
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References
Schier F (2000) Laparoscopic surgery of inguinal hernias in children—initial experience. J Pediatr Surg 35:1331–1335
Lau ST, Lee YH, Caty MG (2007) Current management of hernias and hydroceles. Semin Pediatr Surg 16:50–57
Schier F (2006) Laparoscopic inguinal hernia repair—a prospective personal series of 542 children. J Pediatr Surg 41:1081–1084
Schier F, Montupet P, Esposito C (2002) Laparoscopic inguinal herniorrhaphy in children: a 3 centre experience with 933 repairs. J Pediatr Surg 37:395–397
Montupet P, Esposito C (2011) Fifteen years experience in laparoscopic inguinal hernia repair in pediatric patients. Results and considerations on a debated procedure. Surg Endosc 25:450–453
Esposito C, Montinaro L, Alicchio F et al (2010) Laparoscopic treatment of inguinal hernia in the first year of life. J Laparoendosc Adv Surg Tech 20:473–476
Esposito C, Montinaro L, Alicchio F et al (2009) Technical standardization of laparoscopic herniorraphy in pediatric patients. World J Surg 33:1846–1850
Sneider EB, Jones S, Danielson PD (2009) Refinements in selection criteria for pediatric laparoscopic inguinal hernia repair. J Laparoendosc Adv Surg Tech 19:237–240
Turial S, Enders J, Krause K, Schier F (2011) Laparoscopic inguinal herniorrhaphy in babies weighing 5 kg or less. Surg Endosc 25:72–78
Rescorla FJ, Grosfeld JL (1984) Inguinal hernia repair in the perinatal period and early infancy: clinical considerations. J Pediatr Surg 19:832–837
Misra D, Hewitt G, Potts SR et al (1994) Inguinal herniotomy in young infants, with emphasis on premature neonates. J Pediatr Surg 29:1496–1498
Baird R, Gholoum S, Laberge JM, Puligandla P (2011) Prematurity, not age at operation or incarceration, impacts complication rates of inguinal hernia repair. J Pediatr Surg 46:908–911
Turial S, Enders J, Krause K, Schier F (2010) Laparoscopic inguinal herniorrhaphy in premature infants. Eur J Pediatr Surg 20:371–374
Nagraj S, Sinha S, Grant H, Lakhoo K, Hitchcock R, Johnson P (2006) The incidence of complications following primary inguinal herniotomy in babies weighing 5 kg or less. Pediatr Surg Int 22:500–502
Vogels H, Bruijnen C, Beasley S (2009) Predictors of recurrence after inguinal herniotomy in boys. Pediatr Surg Int 25:235–238
Schier F (2007) The laparoscopic spectrum of inguinal hernias and their recurrences. Pediatr Surg Int 23:1209–1213
Treef W, Schier F (2009) Characteristics of laparoscopic inguinal hernia recurrences. Pediatr Surg Int 25:149–152
Schier F, Turial S, Hückstädt T, Klein KU, Wannik T (2008) Laparoscopic inguinal hernia repair does not impair testicular perfusion. J Pediatr Surg 43:131–135
Zamakhshary M, To T, Langer JC (2008) Risk of incarceration of inguinal hernia among infants and young children awaiting elective surgery. Can Med Assoc J 179:1001–1005
Stylianos S, Jacir NN, Harris BH (1993) Incarceration of inguinal hernia in infants prior to elective repair. J Pediatr Surg 28:582–583
Chen LE, Zamakhshary M, Langer JC (2009) Impact of wait time on outcome for inguinal hernia repair in infants. Pediatr Surg Int 25:223–227
Miyano G, Yamataka A, Okada Y, Shimotakahara A, Kaneko K, Lane GJ, Yamashiro Y, Miyano T (2004) Sigmoidocolocystoplasty for augmentation of iatrogenic small capacity bladder caused by direct injury to the bladder during inguinal hernia repair: longterm follow-up. Pediatr Surg Int 20:61–64
Chung HM, Yu TJ (1999) Bladder rupture after inguinal herniotomy. Pediatr Surg Int 15:584–585
Esposito C, Montupet P (2006) Laparoscopic treatment of recurrent inguinal hernia in children. Pediatr Surg Int 14:182–184
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Esposito, C., Turial, S., Escolino, M. et al. Laparoscopic inguinal hernia repair in premature babies weighing 3 kg or less. Pediatr Surg Int 28, 989–992 (2012). https://doi.org/10.1007/s00383-012-3156-9
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DOI: https://doi.org/10.1007/s00383-012-3156-9