Hidden incision endoscopic surgery: description of technique, parental satisfaction and applications

Area of Science:

• Pediatric surgery
• Minimally invasive surgery
• Surgical oncology

Background:

• Minimally invasive surgery offers advantages over open surgery in pediatrics, including reduced pain and shorter hospital stays.
• Traditional port placement in minimally invasive surgery can result in visible scars, impacting cosmetic outcomes.
• Hidden Incision Endoscopic Surgery (HIdES) was developed to address the issue of scarring in pediatric endoscopic procedures.

Purpose of the Study:

• To evaluate the cosmetic outcomes of the HIdES technique in pediatric patients.
• To compare the patient and parent satisfaction with scar visibility between HIdES, traditional laparoscopic surgery, and open surgery.

Main Methods:

• The HIdES technique involves placing ports below the Pfannenstiel incision line and infraumbilically.
• Procedures such as pyeloplasty and nephrectomy were performed using HIdES.
• Patients and parents compared cosmetic outcomes using validated scales against images of traditional laparoscopic and open surgery.

Main Results:

• HIdES was successfully used in 12 pediatric cases without complications.
• Patients and parents reported statistically higher satisfaction with the cosmetic results of HIdES compared to traditional laparoscopic and open surgery.
• The HIdES technique effectively hides port sites, making them nonvisible when wearing swimwear.

Conclusions:

• The HIdES technique provides excellent cosmetic results by concealing port sites within the Pfannenstiel incision.
• This approach is highly preferred by both pediatric patients and their parents due to improved aesthetics.
• HIdES represents a significant advancement in minimizing visible scarring in pediatric endoscopic surgery.