Initial experience in children using conventional laparoscopic instruments in single-incision laparoscopic surgery.
BACKGROUND
Single-incision laparoscopic surgery (SILS) has been successfully performed in children using 5-mm reticulating instruments. There are, however, few reports investigating the use of conventional instruments in SILS in the pediatric population.


METHODS
We conducted a retrospective review of all consecutive children who underwent SILS from October 2009 to January 2010, with the procedure being solely performed by conventional 3- and 5-mm instruments through a standard access technique.


RESULTS
A total of 19 SILS procedures were successfully performed in children aged 3 to 15 years. They included appendectomy (n = 10), nephrectomy (n = 1), combined cholecystectomy and splenectomy (n = 2), cholecystectomy (n = 1), high ligation for varicocele (n = 2), excision of Meckel diverticulum (n = 1), and staged orchidopexy and exploration for impalpable testis (n = 2). There was one conversion to conventional laparoscopic surgery, and that occurred in our first case of splenectomy. All the patients had smooth recovery from surgery without complications.


CONCLUSIONS
Using conventional instruments in SILS is technically feasible in children from simple to complex procedures and may have the potential to popularize this approach by eliminating the mandatory demand for specially designed instruments.
Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. pyhtam@hotmail.com
Yuk Him
YH
Tam
Kim Hung
KH
Lee
Jennifer Dart Yin
JD
Sihoe
Kin Wai
KW
Chan
Sing Tak
ST
Cheung
Kristine Kit Yi
KK
Pang
D000293:Adolescent; D001062:Appendectomy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data; D004867:Equipment Design; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D008467:Meckel Diverticulum / Q000601:surgery; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D056126:Orchiopexy / Q000295:instrumentation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013156:Splenectomy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D013525:Surgical Instruments; D014646:Varicocele / Q000601:surgery