Abstract
Purpose
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.
Conclusion
Single incision laparoscopic cholecystectomy is safe and feasible to perform in pediatrics, even in the setting of acute disease.
Similar content being viewed by others
References
Tecchino R, Greco F, Matera D (2009) Single-incision laparoscopic cholecystectomy surgery without a visible scar. Surg Endosc 23(4):896–899
Davidoff D, Branum GD, Murray EA, Chong KW, Ware RE, Kinney TR, Pappas TN, Meyers W (1992) The technique of laparoscopic cholecystectomy in children. Ann Surg 215(2):186–191
Mintz Y, Horgan S, Cullen J, Ramamoorty S, Chock A, Savu M, Easter D, Talamini M (2007) Notes: the hybrid technique. J Laparoendosc Adv Surg Tech 17:402–406
Pearl JP, Ponsky G (2008) Natural orifice translumenal endoscopic surgery: a critical review. J Gastrointest Surg 12:1293–1300
Desai M, Berger A, Brandino A, Monish A, Irivine B, Canes D, Desai M, Rao P, Sotelo R, Stein R, Gill I (2007) Laparoendoscopic single-site surgery: initial hundred patients. Urology 74(4):805–812
Frazee RC, Roberts JW, Okeson GC, Symmonds RE, Snyder SK, Hendricks JC, Smith RW (1991) Open versus laparoscopic cholecystectomy: a comparison of postoperative pulmonary function. Ann Surg 213(6):651–654
Navarra G, Pozza E, Occjionorelli S, Carcoforo P, Donini I (1997) One wound laparoscopic cholecystectomy. Br J Surg 84:695
Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizing no incision outside of umbilicus. J Laparoendosc Adv Surg Tech 9:361–364
Esposito C (1998) One-trocar appendectomy in pediatric surgery. Surg Endosc 12:177–178
Karpelowsky J, Numanoglu A, Rode H (2008) Single-port laparoscopic gastrostomy. Eur J Ped Surg 18:285–286
Ponsky TA, Lukish JR (2008) Single site laparoscopic gasrtostomy with a 4 mm bronchoscopic grasper. J Pediatr Surg 43:412–414
Ponsky T, Diluciano J, Chwals W (2009) Early experience with single-port laparoscopic surgery in children. J Laparoendosc Adv Surg Tech 19(4):551–553
Dutta S (2009) Early experience with single incision laparoscopic surgery: eliminating the scar from abdominal operations. J Pediatr Surg 44:1741–1745
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Emami, C.N., Garrett, D., Anselmo, D. et al. Pediatric single incision laparoscopic cholecystectomy: lessons learned in the first 25 cases. Pediatr Surg Int 27, 743–746 (2011). https://doi.org/10.1007/s00383-011-2865-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-011-2865-9