title: Pediatric single incision laparoscopic cholecystectomy: lessons learned in the first 25 cases.
abstract: OBJECTIVE
  We are reporting our experience so far with single incision laparoscopic cholecystectomy in children.
  
  
  METHODS
  After the approval of the institutional review board, we performed a retrospective chart review of our single port cases from 01/2008 to 10/2009. We used operating room (OR) times, length of stay, as well as IV narcotic use as our outcome measures. Pertinent clinical data were extracted. The single port procedure was performed using a single infra-umbilical incision whereby three 5-mm ports were placed.
  
  
  RESULTS
  We identified 25 patients in the single port group (20 females and 5 males). 23 patients in the study group underwent cholecystectomy without intra-operative cholangiogram and one patient had an intra-operative cholangiogram performed. This additional procedure did not add to the overall OR time significantly as compared to simple cholecystectomies. Average OR time was 97.5 min as compared to 71.4 min in the traditional 4-port group. Blood loss was reported as minimal for all cases in both the groups (5-25 ml). There were no intra-operative complications in either group. Mean length of stay was 1.47 days in the study group. All patients in the study group had minimal (1-3 doses) need for intravenous narcotics during their inpatient stay except for one patient, who required more. All patients in the study group had excellent cosmetic results on postoperative follow-up.
  
  
  CONCLUSIONS
  Single incision laparoscopic cholecystectomy is safe and feasible to perform in pediatrics, even in the setting of acute disease.
authors.affiliation: Department of Pediatric Surgery, USC-Keck School of medicine, Childrens Hospital Los Angeles, 4650 Sunset Blvd, MS#100, Los Angeles, CA 90027, USA. claudia.emami@gmail.com
authors.forename: Claudia N
authors.initials: CN
authors.lastname: Emami
authors.forename: Deiadra
authors.initials: D
authors.lastname: Garrett
authors.forename: Dean
authors.initials: D
authors.lastname: Anselmo
authors.forename: Nam X
authors.initials: NX
authors.lastname: Nguyen
mesh_terms: D000293:Adolescent; D002648:Child; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D020706:Laparoscopes; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult