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Updated: Jun 20, 2026
Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review
Published on: March 27, 2026
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
Insights
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.
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.
- 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.
Purpose:
The aim of this study was to determine the safety and efficacy of limited-access laparoscopic procedures in children by using a modified single-port access (SPA) technique.
Methods:
A number of different basic laparoscopic procedures were attempted by using a modified 8-mm operating laparoscope with a 4-mm, 6-degree lens and an incorporated 5-mm operating channel. The operating scope was placed though an umbilical incision. The majority of cases also involved the use of a 3-mm instrument placed through a separate stab-wound incision or 3-mm port. Patient age ranged from 9 months to 16 years and weight from 7 to 60 kg. Procedures included laparoscopic cholecystectomy in 10, appendectomy in 8, enterolysis in 2, ovarian cystectomy in 1, and inguinal hernia repair in 15 patients.
Results:
All procedures, except one, were successfully completed by using the SPA technique. A hernia repair in a 15-year-old male was converted to a three-port laparoscopic repair, because the operating scope could not adequately access the area. Operative times were longer than comparable procedures if using a standard laparoscopic approach, but a statistical analysis was not performed. There were no operative or postoperative complications.
Conclusions:
A modified SPA technique appears to be a safe, viable alternative to a standard laparoscopic approach for some procedures in children. The primary advantage is cosmetic. Visualization and tissue manipulation are more difficult and time consuming. The addition of a single 3-mm instrument at a separate site allows for easier dissection and triangulation, with almost no visible scarring. This may be more beneficial than creating a single 20-mm incision in the umbilicus with multiple ports, with nearly the same cosmetic result.
