Laparoscopic repair of hiatus hernia in infants

Abstract

Objective To investigate the safety and efficacy of the laparoscopic repair of hiatus hernia in infants. Methods Esophageal hiatus repair and Nissen fundoplication was performed in 34 infants with hiatal hernia during September 2001 to January 2010. Three cases were diagnosed as diaphragmatic hernia prenatal ultrasonography at 27 weeks, 32 weeks, and 38 weeks gestational age,respectively. Their diagnoses were confirmed by gastrointestinal contrast radiography after birth. One of the three patients, whose gastrointestinal contrast radiography showed the signs of paraesophageal hernia, volvulus of stomach and gastroesophageal reflux, were performed laparoscopic repair 22 hours later after birth. Some patients underwent extra operations for other problems complicated with hiatus hernia: 1 patient underwent laparoscopic Ladds operation for intestinal malrotation; 1 underwent laparoscopic pyloroplasty for delayed gastric emptying; and 1 had laparoscopic hernia sac ligation for right inguinal hernia. Results The patients were successfully performed laparoscopic esophageal hiatus repair and Nissen fundoplication except 1 converted to open surgery. The youngest patient was only 2 hours after birth. The mean operation time was 122 min (100 min～210 min). The mean blood loss was 5ml (1～10 ml). Feeding started at 24～48 h after surgery. The average postoperative hospital stay was 6. 5 days (4～12days). Twenty six patients were followed up from 1 month to 6 years. One patient vomited in the 6th day after operation, and was improved after gastric motility medicine treatment (Domperidore). The recurrence of hiatus hernia was found in 2 patients at 1 and 1.5 years after operation, and cured after the second laparoscopic hiatus hernia repair. Conclusions Laparoscopic repair for infant hiatus hernia is safe and effective. Key words: Laparoscopic surgical procedures; Hiatal hernia