Is Laparoscopic Fundoplication More Difficult in Infants than in Older Children?

Abstract

Purpose:

Infants and older children who had undergone laparoscopic fundoplication (LF) were reviewed to determine whether the perception that LF is a greater technical challenge in infants is justified.

Patients and Methods:

The hospital case notes of 63 infants and children who had undergone LF during a 4-year period from November 1996 were reviewed. Parameters reflecting operative difficulty (operative time, time to achieve full feeding, duration of hospital stay, and complication rate) were analyzed in relation to the weight of the infant (<10 kg or >10 kg) at the time of surgery. Seventeen patients weighed <10 kg at the time of operation (group A), and 46 weighed >10 kg (group B).

Results:

The median operative time was 87 minutes in group A (range 52-235 minutes) and 105 minutes in group B (range 58-185 minutes) (P = 0.09). The median time to full feeding postoperatively was 2 days in each group. The median postoperative hospital stay was 3.5 days in group A and 2 days in group B (P = 0.05). There was no significant difference in the complication rates in the groups.

Conclusions:

No objective evidence that LF is more difficult in infants than in older children could be identified. The choice of a laparoscopic approach to fundoplication need not be determined on the basis of weight.