Comparing Outcomes of Single-Incision Laparoscopic Herniorrhaphy in Newborns and Infants

Abstract

Background: As surgical techniques progress, laparoscopic herniorrhaphy is now performed more often in premature babies. The aim of this study was to analyze the outcomes of newborns and infants who underwent single-incision laparoscopic herniorrhaphy (SILH) at our center. Methods: We retrospectively reviewed patients younger than 12 months old who received SILH at our department from 2016 to 2020. SILH involved a 5 mm 30-degree scope and 3 mm instruments with a 3-0 Silk purse-string intracorporeal suture for closure of the internal ring. At the time of surgery, Group 1 newborns, whose corrected age was 2 months and below, were compared to the Group 2 infants, whose age was above 2 months. We assessed the patients’ characteristics, anesthesia, surgical data, and complications. Results: A total of 197 patients were included (114 newborns in Group 1 and 83 infants in Group 2). The mean age and body weight in Group 1 were 1.2 months and 3.8 kg, respectively, whereas in Group 2, they were 3.2 months and 6.7 kg, respectively. There were no significant differences in operative time (Group 1 = 34.1 min vs. Group 2 = 32.3 min, p = 0.26), anesthetic time (Group 1 = 80.0 min vs. Group 2 = 76.3 min, p = 0.07), length of hospitalization (Group 1 = 2.3 days vs. Group 2 = 2.4 days, p = 0.88), postoperative complications including omphalitis (Group 1 = 5.3% vs. Group 2 = 1.2%, p = 0.13), wound infection (Group 1 = 0.9% vs. Group 2 = 1.2%, p = 0.81), and hydrocele (Group 1 = 0.35% vs. Group 2 = 8.4%, p = 0.14). No recurrence, testicular ascent or atrophy, or mortality was observed in either group during the 2-year follow-up period. Conclusions: Single-incision laparoscopic herniorrhaphy is a safe and effective operation for inguinal hernia repair in infants, even those with prematurity, lower body weight at the time of surgery, or cardiac and/or pulmonary comorbidities. Comparable results revealed no significant differences in perioperative complications despite younger ages and lower body weights.

Percutaneous Internal Ring Suturing for the Minimally Invasive Repair of Congenital Inguinal Hernia in Neonates: A Retrospective Cohort Study

“…Patkowski et al reported an overall anaesthesia time of 48 minutes [11], which is significantly longer when compared to our data. In a study comparing single-incision laparoscopic herniorrhaphy (SILH) in newborns and infants, the average time under anaesthesia was reported to be 80.0 ± 14.5 minutes for newborns and 76.3 ± 12.9 minutes for infants (p=0.07) [13]. Average anaesthesia times in our study appear to be lower than those in the literature.…”

Pediatric incarcerated inguinal hernia: Traditional open or laparoscopic-assisted approach?

“…[ 9 ] One of the 3 cases occur before the age of 6 months, and the incidence in males is almost 5 to 10 times compared to females. [ 10 , 11 ] Incarceration may occur in 1/6 of indirect inguinal hernias. [ 12 ] When incarceration occurs in an inguinal hernia, it causes an irreducible mass in the groin or scrotum, along with tenderness, redness, and swelling, accompanied by nausea and vomiting, as well as other symptoms.…”