[Initial experience in single site laparoscopic surgery in a pediatric hospital of Bogotá]

Minimally invasive surgery is the current accepted approach for abdominal surgery. However, less invasive techniques such as single incision laparoscopic surgery (SILS) are being used more frequently and we believe it will become the standard choice for abdominal surgery. This report describes our initial experience with Single Port Incision Surgery (SILS).

We reviewed all the patients who underwent SILS in our hospital between November 2009 and July 2011. We used a surgical glove attached to a wound retractor to yield a multi-port hybrid.

We present 80 patients with a mean age of 8.6 years and mean weight of 32,1 kg. The youngest patient was 8 days old and the smallest patient weighed 2.5 kg. The average duration of surgery was 48.2 minutes. The average length of stay was 48.7 hours. Different procedures were performed: appendectomies for early appendicitis (55%), hepatic biopsies (15%), appendectomies for perforated appendicitis (7.5%), and the following isolated cases: cholecystectomy, Meckel's diverticulum resection, oophorectomy, salpingo-oophorectomy, ovarian cystectomy, bowel biopsy, and a resection of an accessory spleen torsion. SILS was successfully completed in 78 cases, and 2 cases were converted to standard laparoscopy and none to open surgery. There were no intraoperative surgical complications. Postoperative complications presented in 5 cases: a superficial incisional site infection, two residual abdominal abscesses, one bowel obstruction and one evisceration. The last two cases subsequently resulted in reoperation and occurred early in our learning curve.

SILS is a reproducible and viable technique that may be used successfully in pediatric surgery. It may be used safely in different procedures and age groups, even in neonates. Time of surgery decreased with our learning curve. Additionally, excellent cosmetic results were obtained as evidenced by imperceptible umbilical scarring.