Minimally Invasive Surgery in Neonates: Ten Years' Experience

Abstract

Background

: This study reviews ten years' experience in our institution with minimally invasive surgery in infants. It evaluates the feasibility, safety, and efficacy of performing advanced endoscopic procedures in infants under 5 kg.

Methods

: From October 1992 through October 2002, 846 infants weighing 1.1 to 5.0 kg underwent 881 procedures using minimally invasive techniques. The majority of the procedures were performed using 3 mm instruments and 2.7 or 4 mm scopes. Procedures include Nissen fundoplication, pyloromyotomy, colon pull-through, patent ductus arteriosus (PDA) closure, Ladd's procedure, colon resection, congenital diaphragmatic hernia repair, tracheoesophageal fistula repair, and exploration.

Results

: Ninety-eight percent of procedures were completed successfully endoscopically. There were two intraoperative complications and no mortality. Days to discharge for patients admitted for their specific procedure were Nissen 1.1, PDA 1.3, pyloromyotomy 1, pull-through 2.6.

Conclusions

: This study demonstrates that advanced endosurgical techniques in infants are safe, effective, and associated with the same benefits as those seen in older patients.