Making baby surgery safer

By Jane Elliott
Health reporter, BBC News

Charlie needed a hernia operation

Charlie Toward was born with a hernia in his groin.

His parents knew he needed surgery to remove the lump, but were advised to wait until after his first birthday when he was stronger to cope with the open surgery.

However, last month, aged only seven months, Charlie was able to have keyhole surgery - thanks to the donation of some special baby equipment to The Royal London Hospital where he was treated.

His mother Lizzie, from Essex, said Charlie was back to normal in no time.

"Charlie's recovery was amazing," she said.

"He was sleepy the next day but was pretty much rolling around and playing around - you would not have known he had an operation.

"He could not jump around in his jumpy toys but he could play in his activity gym.

"I was amazed by how quickly he recovered. You can hardly see any scarring, they have done an amazing job. The operation took about 40 minutes."

Transforming surgery

Paediatric consultant surgeon Niall Jones, a gastrointestinal specialist at The Royal London Hospital, said it was one of the few hospitals able to offer the treatment to such young children because of the tailor-made keyhole surgical equipment.

He said that being able to offer this sort of surgery by keyhole made the operation safer and recovery better.

"Keyhole techniques have transformed many areas of surgery in recent years," he said.

"While conventional keyhole instruments can be used with adults and most children, for very young infants under the age of one, they are simply too big.

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Paediatric consultant surgeon Niall Jones compares the tiny baby keyhole instruments to larger adult ones

"The use of small, laparoscopic equipment has a number of advantages over open surgery. For example, we can avoid invasive access into the abdomen, which can be quite traumatic for a newborn.

"The amount of damage done to tissues is much less with keyhole as it is less invasive.

"With traditional open surgery, the cut needs to be larger and you are pulling and pushing the tissue and damaging things.

"There is less trauma with keyhole, a speedier recovery and less pain relief is needed."

Better outcome

He also said the operations themselves could be improved, for example by reducing the risk during hernia surgery that other tissue, such as sperm ducts, might be damaged.

"In addition, surgeons can check whether a hernia is likely to develop on the other side of the body," Mr Jones added.

INGUINAL HERNIA An inguinal hernia is a lump in the groin that occurs when part of your gut (intestine) pushes through a weakness in the muscles of the abdominal wall. Inguinal hernias are most common in boys and men If a hernia is not treated it is likely to get larger and become more uncomfortable and can cause complications

"If a weakness is identified, it can be repaired there and then - a distinct advantage as up to 10% of infants have to return after conventional surgery to have a second hernia repaired. "

Mr Jones also treats newborn babies with the equipment, in use at the Royal London since May, less common conditions such as gastroesophageal reflux disease (acid reflux from the stomach) and congenital abnormalities.

Lizzie said that even in her own limited experience, the keyhole recovery was better than conventional surgery.

"Another boy we knew through my National Childbirth Trust group had the open surgery before Charlie and he did take longer to heal.

"Baby keyhole instruments did make it a lot easier for Charlie."

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