The problem we are addressing in the HIP Trial is the lack of knowledge regarding whether IH repair in premature infants who are diagnosed while in the NICU is more safely performed, for the majority of infants, prior to discharge (early repair) or ~5 months after NICU discharge (late repair). Additionally, the timing (and duration) of general anesthesia is believed to be an important determinant of neurodevelopmental outcomes beyond infancy. The HIP trial will also compare neurodevelopmental outcomes, as assessed by the Bayley Scales of Infant Development (BSID), 3rd edition, at 2 years corrected age, for infants in the early versus late IH repair groups.
If an infant with a gestational age of less than 37 weeks is diagnosed with an inguinal hernia, parents of the patient will be asked to participate in the randomized trial. If they consent, the patient will be randomized to inpatient (early) or outpatient (late) repair.
A) Inpatient Repair: Inguinal hernia will be repaired before discharge from the NICU. The patient will have a 2 week post-op pediatric surgery clinic appointment.
B) Outpatient Repair: The patient will have a 6-8 week clinic appointment after discharge and before surgery. Surgery will be scheduled about 5 months after discharge from the NICU (55-60 weeks PMA).
All patients will receive monthly phone calls; a 10 month and a 22-26 month follow up appointment