Single-Port Laparoscopy for the Drainage of Abdominal Infected Fluid Collections in Children, With the TriPort System: Initial Experience of 2 Cases

Abstract

Single-port or single-incision laparoscopic surgery has been reported for a number of surgical procedures, including cholecystectomy, appendicectomy, and urological procedures. Single-port thoracoscopic procedures for evacuation of empyema have been described. However, to the authors' knowledge, there has been no report of single-port laparoscopic drainage of abdominal infected fluid collections, especially in children, in the relevant world literature. The authors report the first use of single-port laparoscopy with the TriPort system for drainage of abdominal infected fluid collections in children using the previous open appendicectomy wound. This approach was successfully completed in 2 consecutive children without conversion to open surgery. The operative duration was less than 30 minutes in each case. Both patients had no intraoperative or postoperative complications on follow-up at 8 weeks. Single-port laparoscopy with the TriPort system is safe and technically feasible for the management of pelvic collection and/or abscesses. Also, this technique is useful in multiloculated collections and allows for a washout of the peritoneal cavity at the same time, which is not the case for image-guided drainage. In addition, it also allows checking for the blowout of the appendicectomy stump as the cause for the collection. Finally, it has the advantage of reduced wound morbidity and better cosmesis.

Innovations in Minimally Invasive Surgery in Children

“…The first reported use of singleincision laparoscopy in children was in 2009 when an initial experience of 72 single-incision laparoscopic procedures was reported and showed to be a safe alternative to traditional laparoscopy and open surgery . Many pediatric surgeons around the world now perform many procedures by a single-incision approach, including splenectomy, adrenalectomy, pyloromyotomy, cholecystectomy, appendectomy, and gastrostomy tube placement (Ming et al 2016;Ponsky and Krpata 2011;Rothenberg et al 2009;Agrawal et al 2010).…”