title: Single-incision laparoscopic surgery in diagnosis and treatment for gastrointestinal bleeding of obscure origin in children.
abstract: In this multimedia manuscript with video presentation, we reported our experience of performing single-incision laparoscopic surgery (SILS) on 3 children who presented with gastrointestinal bleeding from congenital small bowel lesions. Preoperative investigations including endoscopy and technetium scintigraphy were all negative in the 3 patients aged 4, 7, and 10 years, respectively. SILS was performed using reusable 3- and 5-mm ports and standard straight instruments. The small bowel lesions were located by SILS and the bowel segment with the pathology was exteriorized through the umbilical wound for extracorporeal resection. The diagnoses of the 3 children were Meckel's diverticulum, ileal duplication cyst, and multiple small bowel vascular malformations. All the 3 children recovered uneventfully from surgery without any complications and required minimal postoperative analgesia. Our experience suggested that SILS is an effective alternative to conventional laparoscopy in both diagnostic and therapeutic functions for children with gastrointestinal bleeding of obscure origin.
authors.affiliation: Department of Surgery, Division of Paediatric Surgery and Paediatric Urology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. pyhtam@surgery.cuhk.edu.hk
authors.forename: Yuk Him
authors.initials: YH
authors.lastname: Tam
authors.forename: Kin Wai
authors.initials: KW
authors.lastname: Chan
authors.forename: Yuen Shan
authors.initials: YS
authors.lastname: Wong
authors.forename: Christopherus H
authors.initials: CH
authors.lastname: Houben
authors.forename: Kristine Kit Yi
authors.initials: KK
authors.lastname: Pang
authors.forename: Siu Yan
authors.initials: SY
authors.lastname: Tsui
authors.forename: Jennifer Wai Cheung
authors.initials: JW
authors.lastname: Mou
authors.forename: Kim Hung
authors.initials: KH
authors.lastname: Lee
mesh_terms: D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D007082:Ileum / Q000601:surgery*; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome