Laparoscopic inguinal hernia repair in premature babies weighing 3 kg or less

Abstract

Laparoscopic inguinal hernia repair for babies weighing 3 kg or less is feasible, safe and perhaps even less technically demanding than open inguinal herniotomy.

Laparoscopic Versus Open Inguinal Hernia Repair in Pediatric Patients: A Systematic Review

“…In our opinion, the higher wound infection rate following OH may be due to the fact that the laparoscopic scars are located higher on the abdominal wall compared with inguinal scars, which are inside the diaper area; for this reason they are subject to urine or fecal contamination, which may lead to a higher infection rate. In fact, studies of LH reported fewer wound infections compared with the infants of similar age operated on through the inguinal approach (0% for Esposito et al 50 versus 2.3% for Nagraj et al 52 ).…”

“…Analyzing the international literature, it seems that neonatal inguinal LH is easier and with fewer complications compared with inguinal hernia repair. 50,52 In a randomized study, Chan 23 found that the mean time to resume full activities did not statistically differ between LH and OH, suggesting that recovery after LH is not faster than that after OH in children. In two other studies, similar time to full feeds and length of hospital stay were reported in the LH and OH groups.…”

“…50 By adding these technical refinements, LH has become an easy approach in tough repairs such as neonatal inguinal hernias. Analyzing the international literature, it seems that neonatal inguinal LH is easier and with fewer complications compared with inguinal hernia repair.…”

“…In addition, it seems that recurrence rate and wound infections in infants were always higher after OH than after LH. [50][51][52] However, the length of follow-up in reviewed series was less for the laparoscopic approach compared with the open operation (2.3 versus 4.2 years, respectively). In our opinion, the higher wound infection rate following OH may be due to the fact that the laparoscopic scars are located higher on the abdominal wall compared with inguinal scars, which are inside the diaper area; for this reason they are subject to urine or fecal contamination, which may lead to a higher infection rate.…”

Inguinal hernia in neonates and ex-preterm: complications, timing and need for routine contralateral exploration

“…Laparoscopic repair of inguinal hernia in premature babies has been reported by some authors with good results [19,20]. Nonetheless, our approach was that of resorting to laparoscopy only as a salvage procedure that turned out to be particularly helpful in patients who experienced a hernia recurrence.…”