Inguinal hernia in early infant is a challenging surgical condition. This study aims to evaluate the efficacy and safety of laparoscopic inguinal hernia repair (LH) for small babies in corrected age 3 months compared with the traditional open inguinal hernia repair (OH).

Medical records were retrospectively reviewed in 232 pediatric patients under corrected age 3 months who underwent inguinal hernia repair from January 1, 2013 to December 31, 2015. The chi-squared and Fisher's exact test were used to analyze the results of the study.

As for operative time, in unilateral/bilateral inguinal hernia repair, OH is faster than LH (p<0.05 vs. p=0.06). But operation time gap is shorter in bilateral hernia than unilateral hernia. As for operation site, bilateral inguinal hernia case was more performed in LH than OH (p<0.05). For comparison with the spontaneous breathing recovery time, there was no statistical difference between the two techniques (p=0.96). As for the recurrence rate, no significant difference was observed between the two techniques (p=0.36), whereas the relative risk of recurrence was higher for OH compared with LH (OR=1.56).

LH is also feasible and safe procedure as OH for small babies in corrected age 3 months for experienced pediatric surgeons.

Purpose
The aim of our study was to provide informative data for surgically treated preterm infants with incarcerated inguinal hernia (IH) in the neonatal intensive care unit (NICU).
Methods
Medical records of 9 preterm infants in NICU who underwent IH repair before NICU discharge between January 2011 and June 2020 were reviewed. The definition of incarcerated IH used was irreducible IH even by pediatric surgeon regardless of the use of sedation. The incarceration rate was calculated and informative data for incarcerated IH patients were collected.
Results
Of 237 IH patients, 9 were diagnosed with an incarcerated IH and underwent emergency repair. At diagnosis of IH, the median age, the median postmenstrual age, and the median body weight were 22 days, 29.7 weeks, and 1,090 g, respectively. The diagnosis interval from IH to incarceration was ranged from 6 to 51 days, and none of them died of surgical procedure-related complications. Strangulation occurred in 4 patients and was treated with small bowel resection and enterostomy.
Conclusion
This study provided informative data for incarcerated IH in preterm infants successfully treated surgically. Close observation is more necessary because the incarceration rate during observation of preterm infants with IH in the NICU is as high as 3.8%.

Purpose
The purpose of the article was to review the thirteen years of experience and evaluate the usefulness of open inguinal hernia repair (OIHR) with transinguinal laparoscopic exploration of contralateral groin (TILE), the prevalence of contralateral patent processus vaginalis (CPPV), and the incidence of metachronous inguinal hernia after negative laparoscopic examination in pediatric patients with unilateral inguinal hernia.
Methods
We analyzed data from children aged 15 years and younger who underwent inguinal hernia repair between 2007 and 2019. We performed an OIHR with TILE to assess the contralateral groin, and TILE was accomplished via ipsilateral hernia sac. We collected the medical records and analyzed demographics, operation-related information, including the prevalence of CPPV and the incidence of metachronous contralateral inguinal hernia (MCIH).
Results
Of the 1,702 patients with unilateral inguinal hernia, 440 patients (25.9%) had CPPV. The risk factors of CPPV were younger age, female, and left inguinal hernia. The operation results of OIHR with TILE, such as postoperative pain, cosmetic results, recurrence rate, and recovery time was similar to other reports, including open and laparoscopic repair, if not better than LIHR. There were no complications associated with transinguinal laparoscopic exploration. Also, 28 patients (2.2%) with obliterated PV still developed an MCIH later.
Conclusion
OIHR with TILE is valuable and safe to detect CPPV in the laparoscopic era. There has been some development (2.2%) of MCIH after negative laparoscopic exploration, which suggested that even though PPV is a significant risk factor for developing a pediatric inguinal hernia, other factors also might be involved in the pathophysiology of pediatric inguinal hernia. OIHR with TILE may be a good surgical option because it compensate for the weakness of OIHR alone and has some advantages of LIHR alone. Two methods can also complement each other and might be tailored to the particular needs of individual patients.