Laparoscopic inguinal herniorrhaphy in babies weighing 5 kg or less

Abstract

Laparoscopic inguinal hernia repair for babies weighing 5 kg or less is feasible, safe, and perhaps even less technically demanding than open herniotomy.

Long-Term Outcomes of Laparoscopic Intracorporeal Inguinal Hernia Ligation in Infants Under 1 Year of Age

“…10 There have been concerns regarding the higher rates of recurrence in laparoscopic surgery (4%) compared with 2% in open surgery, 3 and the articles referenced had patients ranging from 3 months to 18 years. 10,11 Recent articles studying patients under the age of 1 year 4 and babies weighing 5 kg or less 6 have suggested that the recurrence rate may be lower in the subset of patients undergoing laparoscopic surgery under the age of 1 year than those quoted for open procedures. Their reasoning for this is related to the thin sac that needs to be dissected in open surgery and the advantage of a magnified field of view during laparoscopic surgery so that sutures can be positioned precisely.…”

“…However, Turial et al, 6 dealing with babies weighing under 5 kg, found that 4.1% of post-laparoscopic hernia repair required orchidopexy. Our series had a lower rate of 2.4% iatrogenic cryptorchidism, but our mean weight at time of surgery was 5.3 kg, which is higher than the mean weight of 3.9 kg in the cases of Turial et al 6 They calculated a 65.5% increase in risk for secondary high testis for each 1 kg less in weight.…”

“…However, Turial et al, 6 dealing with babies weighing under 5 kg, found that 4.1% of post-laparoscopic hernia repair required orchidopexy. Our series had a lower rate of 2.4% iatrogenic cryptorchidism, but our mean weight at time of surgery was 5.3 kg, which is higher than the mean weight of 3.9 kg in the cases of Turial et al 6 They calculated a 65.5% increase in risk for secondary high testis for each 1 kg less in weight. The group studied by Baird et al 12 of patients under 1 year of age undergoing an open procedure had a rate of iatrogenic cryptorchidism of 0.9% after a minimum of 1 year, but the researchers did not state the mean duration of follow-up.…”

“…5,6 Many of the published articles on laparoscopic pediatric inguinal hernias group their patients together 7,8 and therefore may mask benefits or shortfalls of this approach. The aim of our study was to determine the long-term outcomes of patients who underwent laparoscopic inguinal hernia repair when under the age of 1 year at the time of surgery.…”

Laparoscopic repair on asymptomatic contralateral patent processus vaginalis in children with unilateral inguinal hernia: A centre experience and review of the literature

“…Turial et al . reported a 4% incidence of testicular ascent after laparoscopic inguinal herniotomy in babies weighing 5 kg or less 34 . Schier reported a 0.2% incidence of testicular atrophy just 4 weeks after laparoscopic herniotomy 35 .…”