Experience with minimally invasive surgery in infants

BACKGROUND: This study evaluates the feasibility, safety, and efficacy of p erforming advanced endoscopic procedures in infants under 5 kg. METHODS: Over a gl-month period 183 infants weighing 1.3 to 5.0 kg underwen t 195 procedures using minimally invasive techniques. The majority of the p rocedures were performed using 3.5-mm instruments and 2.7-mm scopes. Proced ures include Nissen fundoplication, pyloromyotomy, colon pull-through, pate nt ductus arteriosus closure, Ladd's procedure, colon resection, congenital diaphragmatic hernia repair, ovarian cyst excision, and exploration. RESULTS: All but two procedures were completed successfully endoscopically. There were two intraoperative complications and no mortality. Days to disc harge for patients admitted for their specific procedure were Nissen 2.1, p atent ductus arteriosus 2, pyloromyotomy 1, and pull-through 3.4. CONCLUSIONS: This study demonstrates that advanced endosurgical techniques in infants is safe, effective, and associated with the same benefit as that seen in older patients. Am J Surg. 1998;176:654-658. (C) 1998 by Excerpta Medica, Inc.