Skip to main content
SpringerLink
Log in

Comparison of laparoscopic percutaneous extraperitoneal closure versus conventional herniotomy in extremely low birth weight infants

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Purpose

Laparoscopic percutaneous extraperitoneal closure (LPEC) has become routine for repairing pediatric inguinal hernia (IH). Reports on the effective repair of IH in challenging cases, such as extremely low birth weight infants (ELBWI) who become symptomatic soon after birth and have surgery before 1 year of age, are rare; and conventional herniotomy (CH) in ELBWI requires extensive experience of neonatal surgery. We compared LPEC with CH for treating ELBWI with IH.

Methods

Consecutive ELBWI with IH treated by either LPEC (n = 17) or CH (n = 22) before 1 year of age between 2012 and 2017 were reviewed. LPEC were performed by consultant pediatric surgeons (CPS; n = 3) with experience of at least 200 cases each. In CH, 11 cases were treated by CPS and 11 by CPS-supervised surgical trainees.

Results

There were no intraoperative complications. Operative time and anesthesia time for bilateral IH repairs were both shorter in LPEC. Postoperative sequelae were recurrence (LPEC; n = 1; repaired by redo LPEC 2 months after the initial repair) and intravenous rehydration (CH; n = 1; for persistent post-anesthetic vomiting). Recovery was unremarkable in all cases without additional analgesia.

Conclusion

LPEC would appear to be a viable option for treating IH in ELBWI, especially bilateral cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Esposito C, Escolino M, Turra F, Roberti A, Cerulo M, Farina A et al (2016) Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era. Semin Pediatr Surg 25:232–240

    Article  PubMed  Google Scholar 

  2. Schier F (1998) Laparoscopic herniorrhaphy in girls. J Pediatr Surg 33:1495–1497

    Article  CAS  PubMed  Google Scholar 

  3. Takehara H, Yakabe S, Kameoka K (2006) Laparoscopic percutaneous extraperitoneal closure for inguinal hernia in children: clinical outcome of 972 repairs done in 3 pediatric surgical institutions. J Pediatr Surg 41:1999–2003

    Article  PubMed  Google Scholar 

  4. Endo M, Watanabe T, Nakano M et al (2009) Laparoscopic completely extraperitoneal repair of inguinal hernia in children: a single-institute experience with 1,257 repairs compared with cut-down herniorrhaphy. Surg Endosc 23:1706–1712

    Article  PubMed  PubMed Central  Google Scholar 

  5. Miyake H, Fukumoto K, Yamoto M, Nouso H, Kaneshiro M, Nakajima H et al (2016) Comparison of percutaneous extraperitoneal closure (LPEC) and open repair for pediatric inguinal hernia: experience of a single institution with over 1000 cases. Surg Endosc 30:1466–1472

    Article  PubMed  Google Scholar 

  6. Sachs M, Damm M, Encke A (1997) Historical evolution of inguinal hernia repair. World J Surg 21:218–223

    Article  CAS  PubMed  Google Scholar 

  7. Pini Prato A, Casaccia G, Arnoldi R (2017) Timing and management of inguinal hernia in the premature baby. Eur J Pediatr Surg 27:472–477

    Article  PubMed  Google Scholar 

  8. Turial S, Enders J, Krause K, Schier F (2010) Laparoscopic inguinal herniorrhaphy in premature infants. Eur J Pediatr Surg 20:371–374

    Article  CAS  PubMed  Google Scholar 

  9. Allen GS, Cox CS Jr, White N, Khalil S, Rabb M, Lally KP (1998) Postoperative respiratory complications in ex-premature infants after inguinal herniorrhaphy. J Pediatr Surg 33:1095–1098

    Article  CAS  PubMed  Google Scholar 

  10. Kokorowski PJ, Wang HH, Routh JC, Hubert KC, Nelson CP (2014) Evaluation of the contralateral inguinal ring in clinically unilateral inguinal hernia: a systematic review and meta-analysis. Hernia 18:311–324

    Article  CAS  PubMed  Google Scholar 

  11. Shono T, Izaki T, Nakahori R, Yoshimaru K (2015) Testicular ascent after laparoscopic percutaneous extraperitoneal closure for inguinal hernias. Eur J Pediatr Surg 25:105–108

    PubMed  Google Scholar 

  12. Wang F, Zhong H, Zhao J (2017) Ascending testis after repair of pediatric inguinal hernia and hydrocele: a misunderstood operative complication. J Pediatr Urol 13:53.e1–53.e5

    Article  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for profit sectors.

Author information

Authors and Affiliations

  1. Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Bunkyo-ku, Tokyo, 113-8421, Japan

    Soichi Shibuya, Go Miyano, Takanori Ochi, Hiroyuki Koga, Geoffrey J. Lane & Atsuyuki Yamataka

  2. Department of Pediatric Surgery, Seirei Hamamatsu General Hospital, Shizuoka, Japan

    Eiji Miyazaki & Takaaki Imaizumi

  3. Department of Pediatric Surgery, Juntendo Urayasu Hospital, Chiba, Japan

    Takashi Mikami & Tadaharu Okazaki

Authors
  1. Soichi Shibuya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eiji Miyazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Go Miyano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takaaki Imaizumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takashi Mikami
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takanori Ochi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hiroyuki Koga
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Geoffrey J. Lane
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tadaharu Okazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Atsuyuki Yamataka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Soichi Shibuya.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shibuya, S., Miyazaki, E., Miyano, G. et al. Comparison of laparoscopic percutaneous extraperitoneal closure versus conventional herniotomy in extremely low birth weight infants. Pediatr Surg Int 35, 145–150 (2019). https://doi.org/10.1007/s00383-018-4386-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-018-4386-2

Keywords

Search

Navigation