Feasibility of laparoscopic inguinal hernia repair in extremely- and very-low-birth-weight infants: a single-center retrospective study.

Abstract

Purpose: Inguinal hernia (IH) occurs frequently in extremely- and very-low-birth-weight (ELBW/VLBW) infants. This study evaluates the feasibility of performing laparoscopic repair (LR) near neonatal intensive care unit (NICU) discharge, by comparing its perioperative outcomes with those of open repair (OR) in ELBW/VLBW infants.

Methods: We retrospectively reviewed infants with birth weight < 1500 g who were diagnosed with IH during NICU hospitalization and underwent IH repair between 2015 and 2023. LR was performed using the laparoscopic percutaneous extraperitoneal closure (LPEC) technique. We compared the patient characteristics, operative variables, and postoperative outcomes between the groups.

Results: Among a total of 49 infants, 31 underwent OR and 18 underwent LR. The LR group had a higher body weight at surgery, a lower prevalence of chronic lung disease, and different sex distribution. Operative and anesthesia times were similar for unilateral repair but shorter with LR for bilateral repair. There were no significant differences in postoperative complications. Three infants from the OR group underwent subsequent umbilicoplasty, and one developed a metachronous contralateral hernia.

Conclusion: LR appears technically feasible with acceptable short-term outcomes and may allow contralateral evaluation and concomitant umbilicoplasty. However, baseline imbalances, the small sample size, and limited follow-up preclude conclusions regarding superiority or equivalence to OR.