Eur J Pediatr Surg 2010; 20(6): 371-374
DOI: 10.1055/s-0030-1261932
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Laparoscopic Inguinal Herniorrhaphy in Premature Infants

S. Turial1 , J. Enders1 , K. Krause1 , F. Schier1
  • 1University Medical Center, Department of Pediatric Surgery, Mainz, Germany
Further Information

Publication History

received April 29, 2010

accepted after revision May 01, 2010

Publication Date:
28 July 2010 (online)

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Abstract

Introduction: We report the clinical, operative, and outcome results in 58 premature infants (with maximum weight of 5 000 g at time of surgery) undergoing laparoscopic herniorrhaphy.

Patients and Methods: This study was designed as a prospective, non-randomized single center feasibility study. The inclusion criteria were: symptomatic inguinal hernia, gestational age up to 37 weeks and maximum weight of 5 000 g at the time of surgery. Out of 58 premature infants (42 boys and 16 girls), 24 had bilateral, 20 had right-sided and 14 had left-sided hernias. 14 (24.1%) infants were operated on for an irreducible hernia.

Results: The median gestational age at birth was 33 weeks (range 23–37) and the median gestational age at operation was 41 weeks (range 33–52). The body weight at surgery ranged from 1 450 g to 5 000 g (median 3 900 g); 11 infants (19%) weighed less than 2 500 g. No intraoperative surgical complications occurred. Anesthesia complications were noted in 7 cases. At median follow-up of 25 months (range 6–51 months), there were 3 hernia recurrences in 2 infants (3.6%). In 5 boys, we observed high testes requiring subsequent orchiopexy. Regression analysis showed that the risk of undescended testes increased by 65.5% for every 1 kilo lower weight at surgery.

Conclusion: Based on our early results, it seems that laparoscopic hernia repair in preterm infants and very low birth weight babies is a safe and feasible procedure and has some procedural benefits compared to the standard open technique.