Surgical outcomes of mini laparoscopic herniorrhaphy in infants

We compared surgical outcomes of mini laparoscopic and open herniorrhaphy in infants.

We enrolled 55 infants undergoing herniorrhaphy, of whom 24 underwent mini laparoscopic herniorrhaphy (bilateral in 17, unilateral in 7) and 31 open herniorrhaphy (bilateral in 9, unilateral in 22). Mean±SD patient age was 7.17±4.21 months in the mini laparoscopic and 5.39±4.11 months in the open groups (p=0.37). During laparoscopy a contralateral patent processus vaginalis of 2 cm or greater was noted and repaired simultaneously in 13 of 20 infants (65%) initially diagnosed with unilateral hernia.

Mean±SD followup was 22.9±10.5 months in the mini laparoscopic group and 20.2±10.5 months in the open group (p=0.20). Contralateral metachronous inguinal hernia manifested in 4 of 22 patients (18%) initially presenting with unilateral hernia in the open group and in no patient in the mini laparoscopic group (p<0.05). Recurrence was noted in 1 of the 40 open herniorrhaphy sites and in none of the 41 mini laparoscopic herniorrhaphy sites (p=0.49). For unilateral repair mean±SD operative time was significantly longer in the mini laparoscopic group (80.00±18.97 minutes) compared to the open group (51.15±23.27 minutes, p<0.05). For bilateral repair mean±SD operative time was comparable between the 2 groups (82.52±14.74 minutes for mini laparoscopy and 95.62±20.62 minutes for open repair, p=0.35).

Mini laparoscopic herniorrhaphy in infants may prevent contralateral metachronous inguinal hernia, and is as safe and effective as open herniorrhaphy. The drawback of mini laparoscopic repair is the longer operative time for unilateral herniorrhaphy, which may be overcome by increased experience.