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Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review

Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review

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Experience with modified single-port laparoscopic procedures in children.

Steven S Rothenberg¹, Kristin Shipman, Suzanne Yoder

¹Department of Pediatric Surgery, The Rocky Mountain Hospital for Children, 1601 East 19th Avenue, Suite 5500 Denver, CO 80218, USA. steverberg@aol.com

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A

|August 22, 2009

Summary

A modified single-port access (SPA) technique is a safe alternative for pediatric laparoscopic surgery, offering cosmetic benefits. While dissection is more challenging, it provides a viable option for select procedures.

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Area of Science:

Pediatric Surgery
Minimally Invasive Procedures
Laparoscopic Surgery

Background:

Laparoscopic surgery is common in children.
Standard laparoscopic approaches often require multiple incisions.
Cosmetic outcomes are a significant consideration in pediatric surgery.

Purpose of the Study:

To evaluate the safety and efficacy of a modified single-port access (SPA) technique for pediatric laparoscopic procedures.
To assess the feasibility of SPA for various common surgeries in children.
To compare the cosmetic benefits of SPA versus standard laparoscopy.

Main Methods:

A modified 8-mm operating laparoscope with an integrated lens and channel was used.
Procedures were performed through an umbilical incision, often with an additional 3-mm instrument port.

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Single Port Donor Nephrectomy

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The study included appendectomy, cholecystectomy, enterolysis, ovarian cystectomy, and inguinal hernia repair in children aged 9 months to 16 years.

Main Results:

The modified SPA technique was successful in all but one case (a hernia repair requiring conversion to multi-port).
Operative times were longer compared to standard laparoscopy, though not statistically analyzed.
No operative or postoperative complications were reported, indicating a high safety profile.

Conclusions:

Modified SPA is a safe and viable alternative for select pediatric laparoscopic surgeries.
The primary advantage of SPA is improved cosmesis with minimal scarring.
While visualization and manipulation are more challenging, the addition of a single auxiliary port enhances dissection and triangulation.