Is It Safe for Trainees to Perform Single-Incision Pediatric Endosurgery Splenectomy?

Raboei, Enaam; Owiwi, Yazeed; Ghallab, Alaa; Zeinelabdeen, Ali; Alsaggaf, Ameen; Zaidan, Mazen; Fayez, Mohamed; Alawi, Ahmad; Atta, Ahmed; Fageeh, Ahmad Al; Fifi, Khalid Al; Sayegh, Murad Al; Banaja, Abdulaziz M; Haddad, Amani; Nefai, Ziyad Al; Aloufi, Turki; Alghamdi, Shaima; Abdulrahim, Ibrahim; Manea, Aljawhara Al; Alharbi, Ibrahim; Sait, Atef; Fallatah, Reemah

doi:10.1089/lap.2018.0530

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…By contrast, SILS surgery in children was first reported in 2010 [ 26 ]. Raboei et al [ 10 ] reported the application of SILS in a series of 39 children patients in 2019, the findings suggesting that this approach was both feasible and safe, and that it didn't increase postoperative complications. However, studies pertaining to massive splenomegaly, particularly in children, are inadequate.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, available literature reported an overall 8–23.3% complication rate of laparoscopy splenectomy [ 34 , 35 ], which included massive intraoperative bleeding, visceral injury, conversion to open surgery, surgical site infection, postoperative intra‐abdominal bleeding, intestinal obstruction, and systemic inflammation. Raboei et al [ 10 ] confirmed that laparoscopic splenectomy surgery was safe and feasible, and when performed by a duly trained team, did not increase the risk of complications or the difficulty in surgery. To identify the independent factors promoting undesirable results in patients, the standards of adverse outcomes were ascertained via a questionnaire survey.…”

Section: Discussionmentioning

confidence: 99%

“…At present, this technique is employed in children's splenectomy surgery. Raboei et al [ 10 ] have confirmed that single-incision laparoscopy was feasible, effective, and safe for splenomegaly. Furthermore, while the safety of single-incision laparoscopic surgery in adult has been validated, the experience with this surgical technique is still very limited in children and young adults.…”

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confidence: 99%

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Selection of surgical modality for massive splenomegaly in children

Li,

Wang,

Chen

et al. 2023

Surg Endosc

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Background Laparoscopic splenectomy (LS), a treatment for both benign and malignant splenic diseases, can prove technically challenging in patients with massive splenomegaly. In particular, the optimal surgical modality for treating massive splenomegaly in children remains controversial. Methods The clinicopathologic data of 289 pediatric patients undergoing splenectomy for massive splenomegaly were studied in a retrospective analysis. Accordingly, the patients were classified into the LS surgery group and open splenectomy (OS) surgery group. In the laparoscopy cohort, they were separated into two subgroups according to the method of surgery: the multi-incision laparoscopic splenectomy (MILS) and the single-incision laparoscopic splenectomy (SILS) surgery groups, respectively. Patient demographics, clinical data, surgery, complications, and postoperative recovery underwent analysis. Concurrently, we compared the risk of adverse laparoscopic splenectomy outcomes utilizing univariable and multivariable logistic regression. Results The total operation time proved remarkably shorter in the OS group in contrast to the LS group (149.87 ± 61.44 versus 188.20 ± 52.51 min, P < 0.001). Relative to the OS group, the LS group exhibited lowered postoperative pain scores, bowel recovery time, and postoperative hospitalization time (P < 0.001). No remarkable difference existed in post-operation complications or mortality (P > 0.05). Nevertheless, the operation duration was remarkably longer in the SILS surgery group than in the MILS surgery group (200 ± 46.11 versus 171.39 ± 40.30 min, P = 0.02). Meanwhile, the operative duration of MILS and SILS displayed a remarkable positive association with splenic length. Moreover, the operative duration of SILS displayed a remarkable positive association with the age, weight, and height of the sick children. Splenic length proved an independent risk factor of adverse outcomes (P < 0.001, OR 1.378). Conclusions For pediatric patients with massive splenomegaly who can tolerate prolonged anesthesia and operative procedures, LS surgery proves the optimal treatment regimen. SILS remains a novel surgery therapy which may be deemed a substitutional surgery approach for treating massive splenomegaly.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Selection of surgical modality for massive splenomegaly in children

Li,

Wang,

Chen

et al. 2023

Surg Endosc

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“…Todavia, Raboei et al (2019) destacou que a esplenectomia através da endocirurgia pediátrica avançada de incisão única (SIPES), foi padronizar a abordagem em idade pediátrica.…”

Section: Característica Do Pré E Intra Operatório De Crianças Na Deci...unclassified

Postoperative benefit of abdominal interventions in children performed by laparoscopic sugery compared with conventinal surgery

Montenegro,

Medeiros,

Carvalho

et al. 2023

CLIUM

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Objective: To compare the postoperative benefits of abdominal interventions in children performed by laparoscopic and open surgery. Method: This is an integrative Literature Review carried out in the LILACS and MEDLINE databases in the Virtual Health Library using the descriptors laparoscopy, “open surgery” and children, associated with the Boolean operator AND and obtaining 30 articles. Results: The sample consisted of 18 articles that met the inclusion and exclusion criteria, in which there was a predominance of articles that evaluated the postoperative result and the effectiveness of laparoscopic surgery, most of which were published in the year 2021. Discussion: The study covers the pre- and intraoperative characteristics of children in the decision of the surgical method, in addition to the construction of the results of the laparoscopic method and its comparison with the conventional approach, regarding the postoperative period of abdominal surgeries in pediatric patients. Conclusion: It was evidenced that the laparoscopic method presents a better visualization of the procedure, less postoperative complications, shorter hospitalization time, less pain and better aesthetic result.

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“…Few centers worldwide are performing SIPES pediatric splenectomy ( Table 2). On extensive review there were only 166 SILS splenectomy cases, out of them only 61 SIPES pediatric splenectomy published in English, German, Greek, French, Italian, or Spanish literatures in all age groups (0.6-90 years) [23][24][25][26][27][28]. No publications regarding the safety of SIPES splenectomy were performed by trainees.…”

Section: Sipes Splenectomymentioning

confidence: 99%

Single-Incision Pediatric Endosurgery (SIPES)

Raboei¹,

Alsaggaf²,

Owiwi³

et al. 2019

Pediatric Surgery, Flowcharts and Clinical Algorithms

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Most centers advocate laparoscopy in order to minimize the size and the number of skin incisions. Many comparative studies, systematic review, and pooled analysis demonstrate that single-incision laparoscopic surgery (SILS) is comparable to conventional laparoscopic surgery (CLS). However, this review identifies the need for randomized controlled trials to clarify the efficacy of SIPS compared with CLS. SIPES pediatric has gained significant popularity. Longer M OT with SIPES was the main concern in most published series. One study has shown that SIPES in children is safe and feasible when performed by resident doctors in comparison to the fellow. We started SIPES in 2003. It is carried out routinely by trainees and specialists. Interferences and collisions between surgical instruments are worse in SIPES than CLS. These challenges extended the OT. Although the use of flexible laparoscopic instruments instead of straight instruments may overcome these technical difficulties, only straight laparoscopic instruments are currently used in our institution. Our aim is to standardize this approach in pediatric age group. The technique can be imparted satisfactorily to trainees. However, its successful incorporation into surgical training programs will depend on the development of innovative simulation strategies.2 appeared in 1992 with appendectomies [4]. In the same year, D'Alessio described a technique for appendectomy in pediatric patients in which a special port was used at the umbilicus to allow the surgeon to bring the appendix out through the umbilicus to perform an extracorporeal appendectomy [5]. 19% of 166 patients in their series required additional trocars, and 4% required conversion to an open operation. The MOT (MOT) was 35 min with a 7-day return to normal activity, compared with 10 days for those that required additional trocars. SIPES has been introduced in our institute by 2003. Now SIPES is our standard technique for many procedures like cholecystectomy, splenectomy, appendectomy, assisted Mitrofanoff, SIPES hernia repair percutaneous internal ring suturing (PIRS), ovarian cystectomy, and fundoplication since 2011. We have performed around 400 SIPES cases up-to-date.

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Is It Safe for Trainees to Perform Single-Incision Pediatric Endosurgery Splenectomy?

Cited by 5 publications

References 16 publications

Selection of surgical modality for massive splenomegaly in children

Selection of surgical modality for massive splenomegaly in children

Postoperative benefit of abdominal interventions in children performed by laparoscopic sugery compared with conventinal surgery

Single-Incision Pediatric Endosurgery (SIPES)

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