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Published on: December 4, 2023
Single-incision laparoscopic surgery in children: initial single-center experience
Carissa L Garey1, Carrie A Laituri, Daniel J Ostlie
1Department of Surgery, The Children's Mercy Hospital, Kansas City, MO 64108, USA.
Insights
Single-incision laparoscopic surgery in children shows comparable outcomes to traditional laparoscopy. Further research is needed to confirm if this minimally invasive approach offers superior benefits.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Laparoscopic Techniques
Background:
- Minimally invasive surgery offers patient benefits.
- Single-incision laparoscopic surgery (SILS) is an advancement.
- This study reports initial pediatric SILS experience.
Purpose of the Study:
- To evaluate the initial experience with single-site procedures in children.
- To assess the feasibility and outcomes of SILS in pediatric patients.
Main Methods:
- Retrospective chart review of pediatric patients.
- Procedures performed between April 2009 and April 2010.
- Analysis of operative times, conversions, and complications.
Main Results:
- 142 procedures included: appendectomies, cholecystectomies, splenectomies, etc.
- 12 conversions to conventional laparoscopy (10 appendectomies, 2 cholecystectomies).
- 6 umbilical surgical site infections after appendectomy; other complications were minimal.
Conclusions:
- Single-incision laparoscopic surgery in children demonstrates comparable outcomes to conventional laparoscopy.
- Preliminary data suggest SILS is a viable option for pediatric surgery.
- Prospective studies are required to establish superiority over conventional laparoscopy.
Background:
In continued efforts to further improve the advantages of minimally invasive surgery to patients, surgeons have developed single-incision laparoscopic techniques. We report our initial experience in children with a variety of single-site procedures.
Method:
A retrospective chart review was performed on patients who underwent a single-site procedure from April 2009 to April 2010.
Results:
There were 142 consecutive procedures: 24 cholecystectomies, 103 appendectomies for nonperforated appendicitis, 2 splenectomies, 1 combined splenectomy/cholecystectomy, 8 ileocecectomies, 2 Meckel diverticulectomies, 1 small bowel duplication resection, and 1 jejunal stricture resection. There were 12 conversions to conventional laparoscopy: 10 during appendectomy and 2 during cholecystectomy. Mean operative time was 34 minutes for appendectomy, 73 minutes for cholecystectomy, 90 minutes for splenectomy, 116 minutes for combined splenectomy/cholecystectomy, 86 minutes for ileocecectomy, and 43 minutes for the small bowel procedures. The only complications were umbilical surgical site infections after appendectomy in 6 patients.
Conclusion:
This institution's preliminary experience suggests that single-incision laparoscopic surgery in children has at least comparable outcomes to conventional laparoscopic surgery. However, prospective data are needed to prove that single-incision laparoscopic surgery is superior to conventional laparoscopy.
