Minimally invasive surgery in newborns weighing less than 2,500 g

Abstract

Newborns (NB) represent a surgical challenge for the surgeon due to their physiological characteristics and reduced surgical spaces. During the last decade, minimally invasive surgery (MIS) has been adopted as a treatment for this group of patients. To report our experiences of MIS on NB weighing less than 2,500 grams. A retrospective descriptive study was conducted analyzing the records of newborns weighing less than 2,500 g and subjected to MIS between April, 2009 and 2012. No patients were excluded. 25 newborns participated on this study; among the treated conditions, congenital diaphragmatic hernia (1), Esophageal Atresia (4 complete repairs and 2 fistula ligation), duodenal obstruction (7), Gastroesophageal reflux disease (6 Nissen procedures, 4 including gastrostomy), Laparoscopic gastrostomy (2) Intestinal obstruction (two bowel resections, end to end anastomosis), and Hypertrophic pyloric stenosis (1). The average weight was 1,920 g (1,300-2,490 g) and 10 of the infants were preterm newborns. 3 mm instruments were used, 5 mm optic 30°. Neither intraoperative complications nor conversions were observed. A patient with tracheoesophageal atresia presented a fistula at the site of anastomosis with spontaneous resolution. MIS has revolutionized surgery, resulting in less intestinal adhesions, postoperative pain, shorter hospital stays and better aesthetic results. Due to the availability of smaller size materials, these procedures could be performed safely.