Experience with the Bailez technique for laparoscopic access in children.
OBJECTIVE
We describe a variation of the Hasson technique for laparoscopic access.


METHODS
All laparoscopic procedures performed in children and completed between September 1999 and May 2002 at 2 institutions were reviewed retrospectively. All access to the peritoneal cavity was accomplished in the same manner using the following approach-a small semicircumferential incision was made in the inferior part of the umbilicus, and the umbilical skin was dissected to expose the area of the umbilical scar where the peritoneum and the skin meet. At this point the peritoneum was opened under direct vision without an incision. A blunt trocar was then easily introduced into the peritoneal cavity without forceful manipulation. The rest of the procedure was accomplished as usual.


RESULTS
Seventy-seven laparoscopic procedures were completed in 77 patients (mean age 4.8 years, range 1 month to 17.75 years). Patient weight ranged from 8 to 66 kg. The procedures included diagnostic laparoscopy for undescended testis (52), varicocelectomy (11), nephrectomy (6), nephroureterectomy (1) and others (7). All attempts were successful. Mean followup was 15.9 months.


CONCLUSIONS
The most important advantage of this technique is that it offers easy and safe access to the peritoneal cavity even in obese individuals. In addition, this access is rapidly accomplished and offers good cosmetic results.
Franc-Guimond
Julie
J
Division of Pediatric Urology, Thomas Jefferson University, Alfred I. Dupont Hospital for Children, 1600 Rockland Road, PO Box 269, Wilmington, DE 19899, USA.
Kryger
John
J
González
Ricardo
R
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009392:Nephrectomy / Q000379:methods; D011677:Punctures / Q000379:methods*; D013520:Urologic Surgical Procedures / Q000379:methods*; D014646:Varicocele / Q000601:surgery