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Comparison of laparoscopic percutaneous extraperitoneal closure versus conventional herniotomy in extremely low birth

Soichi Shibuya1, Eiji Miyazaki2, Go Miyano3

  • 1Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Bunkyo-ku, Tokyo, 113-8421, Japan. soshibu@juntendo.ac.jp.

Pediatric Surgery International
|November 4, 2018
PubMed

Insights

Laparoscopic percutaneous extraperitoneal closure (LPEC) is a safe and effective method for treating inguinal hernias (IH) in extremely low birth weight infants (ELBWI). This technique offers shorter operative times, especially for bilateral cases, compared to conventional herniotomy.

Area of Science:

  • Pediatric Surgery
  • Minimally Invasive Surgery
  • Neonatal Surgery

Background:

  • Inguinal hernia (IH) repair in extremely low birth weight infants (ELBWI) presents unique challenges.
  • Conventional herniotomy (CH) in ELBWI requires specialized neonatal surgical expertise.
  • Laparoscopic percutaneous extraperitoneal closure (LPEC) is a standard procedure for pediatric IH.

Purpose of the Study:

  • To compare the efficacy and safety of LPEC versus CH for treating IH in ELBWI.
  • To evaluate outcomes in infants operated on before one year of age.

Main Methods:

  • A retrospective review of consecutive ELBWI with IH treated between 2012 and 2017.
  • Comparison of LPEC (n=17) versus CH (n=22) groups.
  • LPEC performed by experienced consultant pediatric surgeons (CPS).

Main Results:

  • No intraoperative complications were reported in either group.
  • LPEC demonstrated shorter operative and anesthesia times for bilateral IH repairs.
  • One recurrence in the LPEC group (repaired with redo LPEC) and one case of post-anesthetic vomiting requiring rehydration in the CH group.

Conclusions:

  • LPEC is a viable and effective surgical option for treating inguinal hernias in ELBWI.
  • LPEC is particularly advantageous for managing bilateral IH in this vulnerable population.
  • The study supports the use of LPEC for challenging pediatric IH cases.
Abstract

Keywords:
Conventional herniotomyExtraperitoneal approachExtremely low birth weight infantsInguinal herniaLaparoscopic percutaneous extraperitoneal closureLaparoscopic surgery

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