TY - JOUR
T1 - Cholecystectomy using single-incision pediatric endosurgery
T2 - Technique and initial experience in the first 25 cases
AU - Nougues, Cecilia Puga
AU - Harmon, Carroll M.
AU - Hansen, Erik N.
AU - Georgeson, Keith E.
AU - Muensterer, Oliver J.
PY - 2010/6/1
Y1 - 2010/6/1
N2 - Background: Laparoscopic cholecystectomy has become the standard, in most pediatric surgery centers. In the search for a less-invasive procedure, a single-incision laparoscopic approach has been reported in adults and very few children. Objective: The aim of this study was to present our initial experience of cholecystectomy, using single-incision pediatric endosurgery (SIPES), including the technique, the intraoperative challenges, and the outcome. Methods: All pediatric patients who underwent a SIPES cholecystectomy from March through September 2009 were prospectively evaluated. Results: Twenty-five children underwent a SIPES cholecystectomy. The most frequent indications were symptomatic cholelithiasis in 17 patients (68%) and biliary dyskinesia in 5 (20%). Five patients had sickle-cell anemia. The mean operative time was 73 minutes (range, 30-122). Median hospital stay was 1 day. In 17 patients (68%), a percutaneous 2-mm grasper was used to retract the gallbladder over the liver. No complications were noted, and no conversion to an open procedure was required. In 5 patients, additional trocars were added. On follow-up, 3 days to 2 months later, no complications were noted. No patients were readmitted, and there were no wound infections. Conclusions: Cholecystectomy, when using the SIPES approach in children, is a safe, reasonable alternative to conventional laparoscopy, leaving an inconspicuous scar. Whether SIPES offers any further benefit to the patient, besides improved cosmesis, should be evaluated in future studies.
AB - Background: Laparoscopic cholecystectomy has become the standard, in most pediatric surgery centers. In the search for a less-invasive procedure, a single-incision laparoscopic approach has been reported in adults and very few children. Objective: The aim of this study was to present our initial experience of cholecystectomy, using single-incision pediatric endosurgery (SIPES), including the technique, the intraoperative challenges, and the outcome. Methods: All pediatric patients who underwent a SIPES cholecystectomy from March through September 2009 were prospectively evaluated. Results: Twenty-five children underwent a SIPES cholecystectomy. The most frequent indications were symptomatic cholelithiasis in 17 patients (68%) and biliary dyskinesia in 5 (20%). Five patients had sickle-cell anemia. The mean operative time was 73 minutes (range, 30-122). Median hospital stay was 1 day. In 17 patients (68%), a percutaneous 2-mm grasper was used to retract the gallbladder over the liver. No complications were noted, and no conversion to an open procedure was required. In 5 patients, additional trocars were added. On follow-up, 3 days to 2 months later, no complications were noted. No patients were readmitted, and there were no wound infections. Conclusions: Cholecystectomy, when using the SIPES approach in children, is a safe, reasonable alternative to conventional laparoscopy, leaving an inconspicuous scar. Whether SIPES offers any further benefit to the patient, besides improved cosmesis, should be evaluated in future studies.
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U2 - 10.1089/lap.2009.0405
DO - 10.1089/lap.2009.0405
M3 - Article
C2 - 20459327
AN - SCOPUS:77954179661
SN - 1092-6429
VL - 20
SP - 493
EP - 496
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques
JF - Journal of Laparoendoscopic and Advanced Surgical Techniques
IS - 5
ER -