Transumbilical Single-Incision Laparoscopic Surgery in Children with Conventional Instruments: Our Early Experience.
OBJECTIVE
Laparoscopic surgery is the current accepted approach in most pediatric surgical centers. In an attempt to further minimize the surgical trauma and improve cosmetic outcome, new techniques with a single incision through the umbilicus have been proposed and we believe they will become the standard choices for pediatric surgery. This report describes our initial experience with transumbilical single-incision laparoscopic surgery (TSILS) in children with conventional instruments.


METHODS
A retrospective review of 82 pediatric patients who underwent TSILS in children with conventional instruments from January 2011 to June 2015 was performed. The operations included 56 appendectomies, 9 cholecystectomies, and 17 spermatic vein ligations.


RESULTS
The average age by procedure was 6.2 years for appendectomy (range of 3-14 years); 12.4 years for cholecystectomy (range of 10-14 years); and 12.8 years for spermatic vein ligation (range of 11-14 years). The average operative time was 32 minutes for appendectomy (range of 25-56 minutes); 54 minutes for cholecystectomy (range of 35-95 minutes); and 23 minutes for spermatic vein ligation (range of 17-41 minutes). The average length of staying in hospital was 3 days (range of 2-5 days). All of the operations in 82 cases were successful. None required conversion to open or conventional laparoscopic surgery. There was no obvious wound pain. In addition, there were no wound infections on umbilicus and any other intraoperative complications. There was no obvious scar at patients' umbilicus after postoperative follow-up for 2-4 weeks.


CONCLUSIONS
TSILS is a safe and viable technique that may be used successfully in pediatric surgery. Additionally, excellent cosmetic results are obtained as evidenced by imperceptible umbilical scarring.
1 Department of Pediatric Surgery, Qilu Hospital, Shandong University , Jinan, China .|2 Department of Pediatric Surgery, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University , Wenzhou, China .
Xiao-Kun
XK
Lin
2 Department of Pediatric Surgery, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University , Wenzhou, China .
Da-Zhou
DZ
Wu
2 Department of Pediatric Surgery, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University , Wenzhou, China .
Jing-Li
JL
Cai
2 Department of Pediatric Surgery, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University , Wenzhou, China .
Cong-De
CD
Chen
1 Department of Pediatric Surgery, Qilu Hospital, Shandong University , Jinan, China .
Ke-Lai
KL
Wang
D000293:Adolescent; D001062:Appendectomy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002921:Cicatrix; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D061646:Operative Time; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014472:Umbilicus; D014646:Varicocele / Q000601:surgery*
conventional; laparoscopic surgery; single-incision; transumbilical