Bulletin Autumn‧Winter 2004

Inguinal Hernia Surgery I nguinal hernia is one of the most common surgical problems in young children, occurring in about 20 per cent of pre-term infants. Surgical repair of the inguinal hernia is the only definitive and effective treatment. Traditional surgical repair, performed via an open inguinal exploration, requires a bigger incision and carries the risk of damage to the vas deferens and testicular vessels. A contralateral hernia also occurs in about 20 to 30 per cent of cases. The new method to repair inguinal hernia in infants and children combines the use of the laparoscope and a specially made herniotomy hook designed and named after the division head Prof. Yeung Chung-kwong. The laparoscope enables clear visualization of the hernial defect and neighbouring structures, and accurate assessment of the presence of a contralateral hernia, thus avoiding unnecessary exploration. The herniotomy hook allows complete dissection and ligation of the hernial sac under laparoscopic guidance while safeguarding the vas and testicular vessels. If a contralateral hernia is present, it can be repaired simultaneously and in similar fashion, thereby eliminating the need for a second operation. A l l patients are discharged on the same day. Post- operative pain is minimal w i th nearly all children resuming normal activities the day after. HK's First Frozen-Egg and Frozen-Sperm Baby A healthy baby was born on 29th A p r i l 2004 following the transfer of blastocysts derived from frozen-thawed eggs fertilized w i th frozen-thawed sperm. The good news was announced by the Assisted Reproduction Technology Team of the Faculty of Medicine. To the best of the Team's knowledge, this is the first report in Hong Kong of a live birth using this method. The patient was a 37-year-old woman who had a five-year history of tubal occlusion. A total of 23 eggs were collected from the woman and frozen. Fourteen were thawed and 10 survived. These were inseminated w i th her husband's frozen-thawed sperm using the i n t r ac y t op l asmic sperm injection (ICSI) technique. Eight eggs were fertilized and developed into early embryos on the third day. Two embryos developed into blastocysts on day five and were transferred back to the woman's uterus. On the 35th week of gestation, a healthy baby boy weighing 3.14 kg was born. Successful pregnancies using frozen- thawed human eggs are difficult to achieve. According to a recent survey, fewer than 70 live births have been reported throughout the world in the past 15 years. The potential applications of the ICSI technique in assisted reproduction include problematic sperm p r oduc t i on at the time of egg collection, egg dona t i on programmes, and in countries prohibiting embryo freezing, preservation of fertility for y o u ng women w i t h malignancy p r i or to radiotherapy or chemotherapy. Supportive Therapy for Cancer Treatment-induced Complications C hemotherapy is one of the mainstays of therapy for cancer patients. In Hong Kong, 10 per cent of cancer patients carry the Hepatitus B virus. Chemotherapy may lead to reactivation, resulting in varying degrees of liver damage and death. A s t udy by the Depa r tment of C l i n i cal Oncology, published in the Journal of Clinical Oncology, shows that the a n t i - v i r al d r u g, lamivudine, can reduce the incidence of both hepatitis and its reactivation du r i ng and after chemotherapy. It also appears that lamivudine can prevent reactivation-associated mortality. Breast cancer patients suffer from a higher risk of lymphedema, which is the accumulation of l ymph in the interstitial spaces of the body, a frequent complication of cancer and its therapies. Chinese University Bulletin Autumn • Winter 2004 70