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Laparoscopic inguinal hernia repair in premature babies weighing 3 kg or less
C Esposito1, S Turial, M Escolino
1Department of Pediatrics, Pediatric Surgery, Federico II University of Naples, Via Pansini 5, Naples, 80131, Italy. ciroespo@unina.it
Insights
Laparoscopic inguinal hernia repair is a safe and feasible option for infants weighing 3 kg or less. This minimally invasive approach shows a low complication rate, making it a viable alternative to open surgery.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Neonatal Care
Background:
- Inguinal hernias are common in infants, particularly premature neonates.
- Traditional open repair can be challenging in very small infants.
- Laparoscopic techniques offer potential advantages in terms of visualization and tissue handling.
Purpose of the Study:
- To assess the feasibility, safety, and complication rates of laparoscopic inguinal hernia repair in neonates weighing 3 kg or less.
- To compare the outcomes of laparoscopic repair with open herniotomy in this specific infant population.
Main Methods:
- Retrospective analysis of 67 infants (47 boys, 20 girls) weighing ≤3 kg who underwent laparoscopic hernia repair over a 3-year period.
- Use of a 5-mm scope and 2-3 mm instruments for inner inguinal ring closure with non-absorbable suture.
- Median surgical weight was 2,600 g; most infants were premature.
Main Results:
- 15.0% of infants presented with irreducible hernias; 3 underwent concurrent transumbilical appendectomy.
- Minor anesthesia-related issues occurred in 4 cases.
- Hernia recurrence rate was 4.4% (3/67); no testicular atrophy was observed. 12 cases of undescended testes were noted in 10 boys, with 4 requiring orchiopexy.
Conclusions:
- Laparoscopic inguinal hernia repair is feasible and safe for infants weighing 3 kg or less.
- The procedure may be less technically demanding than open inguinal herniotomy in this patient group.
- Laparoscopic repair demonstrates acceptable outcomes regarding recurrence and complications in neonates.
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.