Abstract
Objective
With advances in clinical medicine, many premature babies nowadays can have excellent survival outcomes. As the incidence of inguinal hernias in this group is high and there is scarce data in the literature regarding the optimal timing for repair, this study aims to review our experience in laparoscopic repair in premature infants.
Methods
In our centre, premature neonates with inguinal hernia noted during hospitalization were offered laparoscopic repair when the body weights reached 2.5 kg unless there is contraindication for laparoscopy. A retrospective review was carried out for all premature neonates who underwent laparoscopic inguinal hernia repair from 2001 to 2011. The operative results, complications, incarceration risk and postoperative apnea risk were recorded.
Result
A total of 79 premature neonates received laparoscopic inguinal hernia repair during this period. The mean gestational age at birth was 31.9 weeks (27–36 weeks) and the mean gestational age at operation was 46.5 weeks (33–92 weeks). One patient had incarceration and required emergency operation while waiting for the elective repair. The mean operative time was 44.9 min (25–93 min). One patient (1.3 %) had recurrence. No postoperative apnea was noted in any patient.
Conclusion
Laparoscopic hernia repair is safe and feasible in premature neonates when they attain reasonable body size, as long as there is excellent anaesthesia support. Low risk of incarceration was noted in this study and it is worth waiting for the body weight to build up and hence facilitate laparoscopic repair.
Similar content being viewed by others
References
Chan KL, Chan HY, Tam PK (2007) Towards a near-zero recurrence rate in laparoscopic inguinal hernia repair in pediatric patients of all ages. J Pediatr Surg 42(12):1993–1997
Turial S, Enders J, Krause K (2011) Laparoscopic inguinal herniorrhaphy in babies weighing 5 kg or less. Surg Endosc 25:72–78
Turial S, Enders J, Krause K et al (2010) Laparoscopic inguinal herniorraphy in premature infants. Eur J Pediatr Surg 20:371–374
Lee SL, Gleason JM, Sydorak RM (2011) A Critical review of premature infants with inguinal hernias: optimal timing of repair, incarceration risk, and postoperative apnea. J Pediatr Surg 46:217–220
Lautz TB, Raval MV, Reynolds M (2011) Does timing matter? A national perspective on the risk of incarceration in premature neonates with inguinal hernia. J Pediatr 158:573–577
Uemura S, Woodward AA, Amerena R et al (1999) Early repair of inguinal hernia in premature babies. Pediatr Surg Int 15:36–39
Vaos G, Gardikis S, Kambouri k et al (2010) Optimal timing for repair of an inguinal hernia in premature infants. Pediatr Surg Int 26:379–385
Murphy JJ, Swansin T, Ansermino M et al (2008) The frequency of apneas in premature infants after inguinal hernia repair: do they need overnight monitoring in the intensive care unit? J Pediatr Surg 43:865–868
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chan, I.H.Y., Lau, C.T., Chung, P.H.Y. et al. Laparoscopic inguinal hernia repair in premature neonates: is it safe?. Pediatr Surg Int 29, 327–330 (2013). https://doi.org/10.1007/s00383-012-3240-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-012-3240-1