Laparoscopic inguinal herniorrhaphy in premature infants.
BACKGROUND
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.


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.


CONCLUSIONS
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.
Turial
S
S
University Medical Center, Department of Pediatric Surgery, Mainz, Germany. salmai.turial@unimedizin-Mainz.de
Enders
J
J
Krause
K
K
Schier
F
F
D005240:Feasibility Studies; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D010535:Laparoscopy; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome