Early Experience with Single-Port Laparoscopic Surgery in Children

Introduction: The current paradigm in laparoscopic surgery is for each instrument to enter the abdomen through its own separate incision. The advent of newer laparoscopic trocars and instruments now allows for all instruments to enter through a single incision. This may lead to less pain and improved cosmetic outcome. Single-incision laparoscopic surgery (SILS) has recently been described in adults. In this article, we report our preliminary experience of SILS in children. Methods: A retrospective review was performed of the operative database at Rainbow Babies and Children's Hospital (Cleveland, OH) from March 2008 to March 2009, looking for all cases that were performed through a single laparoscopic incision. Results: A total of 72 SILS cases were performed. These included cholecystectomy, splenectomy, intussusception reduction, gastrostomy tube placement, thoracoscopic lung biopsy, thoracoscopic decortication, and appendectomy. Five appendectomies were converted to traditional three-port laparoscopy. There were two umbilical wound infections after an appendectomy. There were no other complications. Conclusion: Preliminary experience with SILS in children appears to be safe and effective. Greater numbers and a prospective trial will be necessary to assess the true benefit of this approach.