Laparoscopic Single Site Surgery: Initial Experience and Description of Techniques in the Pediatric Population

Kocherov, Stanislav; Lev, Genady; Shenfeld, Ofer Z.; Chertin, Boris

doi:10.1016/j.juro.2011.03.100

Cited by 18 publications

(7 citation statements)

References 17 publications

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“…Several case series of laparoscopic single-site procedures 7,15,16 have demonstrated this. In our group of patients weighing below 10 kg, trocar crowding and instrument clashing occurred significantly less often compared with those patients operated on with the X-Cone.…”

Section: Discussionmentioning

confidence: 87%

“…15,[18][19][20] However, operating times exceeded up to 300 minutes in 1 case of nephrectomy, which is considered to be significantly longer than in conventional laparoscopy as recently published in a own series of 23 cases. 4 Other authors documented rather longer operating times with a mean of 192.2 minutes for LESS, 219.3 minutes for conventional laparoscopy, and even 127.…”

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confidence: 96%

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Weight-Adapted Surgical Approach for Laparoendoscopic Single-Site Surgery in Pediatric Patients Using Low-Cost Reusable Instrumentation: A Prospective Analysis

Szavay

Luithle

Nagel

et al. 2013

Journal of Laparoendoscopic & Advanced Surgical Techniques

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LESS for pediatric patients can be done safely and efficiently with even less trauma than in conventional laparoscopy irrespective of age and weight. However, different surgical approaches have to be considered as disposable single-site ports are not available for infants and small children. To decrease operative expenses, conventional multiuse trocars and a multiuse single-site port were used with conventional laparoscopic instruments.

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Section: Discussionmentioning

confidence: 87%

mentioning

confidence: 96%

Weight-Adapted Surgical Approach for Laparoendoscopic Single-Site Surgery in Pediatric Patients Using Low-Cost Reusable Instrumentation: A Prospective Analysis

Szavay

Luithle

Nagel

et al. 2013

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…[15][16][17] There have been only a few retrospective case series looking at the feasibility and success of LESS in the urologic pediatric population. [18][19][20] Moreover, there is no published data on LESS from Canada. In 2010, Koh and colleagues reported one of the first series of pediatric nephrectomies with LESS in 11 patients, with a mean age of 5.7 years.…”

Section: Discussionmentioning

confidence: 99%

“…They found no difference in the mean operative time, length of stay, and narcotic requirements with a similar cohort of patients who underwent conventional laparoscopy. 19 In 2011, we presented the use of single incisional laparoscopic sugery (SILS) approach in a series of children who underwent 1-and 2-stage orchidopexy. 21 This involved a single skin incision, but multiple fascial incisions through which the trocars were placed.…”

Section: Discussionmentioning

confidence: 99%

Laparo-endoscopic Single Site Surgery in Pediatrics: Feasibility and surgical outcomes from a preliminary prospective Canadian experience.

Khambati

Wehbi

Farhat

2015

CUAJ

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Introduction: Laparo-endoscopic single-site surgery (LESS) is becoming an alternative to standard laparoscopic surgery. Proposed advantages include enhanced cosmesis and faster recovery. We assessed the early post-operative surgical outcomes of LESS surgery utilizing different instruments in the pediatric urological population in Canada. Methods: We prospectively captured data on all patients undergoing LESS at our institution between February 2011 and August 2012. This included patient age, operative time, length of stay, complications and short-term surgical outcomes. Different instruments/devices were used to perform the procedures. Access was achieved through a transumbilical incision. Results: A total of 16 LESS procedures were performed, including seven pyeloplasties, four unilateral and one bilateral varicocelectomies, two simple nephrectomies, one renal cyst decortication and one pyelolithotomy. There was no statistical difference in the operative times, hospital length of stay and cost (pyeloplasty only) in patients undergoing pyeloplasty and varicocelectomy using the LESS technique when compared to an age matched cohort of patients managed with the traditional laparoscopic approach. One pyeloplasty in the LESS group required conversion to open due to a small intra-renal pelvis. There were no immediate or short term post-operative complications; however, one patient experienced a decrease in renal function status post LESS pyeloplasty. Since all procedures were performed by a vastly experienced surgeon at a tertiary center, the generalizability of the results cannot be assessed. Conclusions: There are only a few series that have assessed the role of LESS in pediatric urological surgery. Although our experience is limited by a heterogeneous group of patients with a short follow-up period, the present cohort demonstrates the safety and feasibility of LESS. Further evaluation with randomized studies is required to better assess the role of LESS in pediatric urology.

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“…Later Dutta reported the first SIPES splenectomy in 2012 [7]. Recently still few centers worldwide have advanced pediatric SIPES [7][8][9][10][11][12][13].…”

Section: Limitations Of Sipesmentioning

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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Laparoscopic Single Site Surgery: Initial Experience and Description of Techniques in the Pediatric Population

Cited by 18 publications

References 17 publications

Weight-Adapted Surgical Approach for Laparoendoscopic Single-Site Surgery in Pediatric Patients Using Low-Cost Reusable Instrumentation: A Prospective Analysis

Weight-Adapted Surgical Approach for Laparoendoscopic Single-Site Surgery in Pediatric Patients Using Low-Cost Reusable Instrumentation: A Prospective Analysis

Laparo-endoscopic Single Site Surgery in Pediatrics: Feasibility and surgical outcomes from a preliminary prospective Canadian experience.

Single-Incision Pediatric Endosurgery (SIPES)

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