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Updated: Jun 8, 2026
Single Port Donor Nephrectomy
Published on: March 12, 2011
Single-incision pediatric endosurgery: lessons learned from our first 224 laparoendoscopic single-site procedures in
Erik N Hansen1, Oliver J Muensterer, Keith E Georgeson
1Department of Pediatric Surgery, Vanderbilt University, Nashville, TN, USA.
Purpose:
To identify technical difficulties during single-incision pediatric endoscopic surgery (SIPES) cases and to highlight solutions.
Materials And Methods:
After IRB approval, all SIPES cases were prospectively collected, and the surgeons involved were polled for technical difficulties encountered and their operative solutions.
Results:
Over a period of 13 months, 224 pediatric SIPES cases were performed in 223 pediatric patients (92 female, 131 male) aged 3 weeks to 19 years. Among these were 130 appendectomies, 32 pyloromyotomies, 32 cholecystectomies, 11 inguinal hernia repairs, 6 Nissen fundoplications and 4 laparoscopic-assisted endorectal pullthrough procedures. Eighteen procedures (8%) employed a primary extra-umbilical instrument in addition to the transumbilical trocar(s). Thirty procedures (13%) begun via a single-site technique required additional trocars for completion. None required laparotomy. Intraoperative complications are discussed. The main challenges of SIPES are: (1) variable umbilical anatomy, (2) large size of current proprietary multitrocar devices, (3) trocar crowding, (4) intra-abdominal exposure, (5) fewer degrees of freedom, (6) clashing instruments, (7) in-line endoscope viewing, and (8) limited number of working ports. We discuss coping strategies to address these issues.
Conclusion:
Many of the drawbacks of SIPES can be overcome by specific techniques, which can make SIPES procedures more broadly feasible and applicable within pediatric endosurgery.
