Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children
Transumbilical laparoscopic assisted appendectomy combines laparoscopic single port dissection with open appendectomy after exteriorization of the appendix through the port site. Compared to the conventional three-port approach, this technique provides an alternative with excellent cosmetic outcome....
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doaj-6bad8727c037400887133b9955f5096f2020-11-24T22:26:13ZengPAGEPress PublicationsLa Pediatria Medica e Chirurgica0391-53872420-77482016-12-0138310.4081/pmc.2016.133123Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in childrenPaul Anthony Karam0Amy Hiuser1David Magnuson2Federico Gian Filippo Seifarth3Department of Pediatric Surgery, Cleveland Clinic Foundation, Cleveland, OHDepartment of General Surgery, Sanford Aberdeen Clinic, Aberdeen, SDDepartment of Pediatric Surgery, Cleveland Clinic Foundation, Cleveland, OHDepartment of Pediatric Surgery, Kalispell Regional Medical Center, Kalispell, MTTransumbilical laparoscopic assisted appendectomy combines laparoscopic single port dissection with open appendectomy after exteriorization of the appendix through the port site. Compared to the conventional three-port approach, this technique provides an alternative with excellent cosmetic outcome. We developed a safe and effective technique to perform an intracorporeal single port appendectomy, using the same laparoscope employed in the extracorporeal procedure. Retrospective review of 71 consecutively performed intracorporeal single port appendectomies and 30 conventional three-port appendectomies in children 6 to 17 years of age. A straight 10-mm Storz telescope with inbuilt 6 mm working channel is used to dissect the appendix, combined with one port-less 2.3 mm percutaneous grasper. Polymer WECK® hem-o-lock® clips are applied to seal the base of the appendix and the appendiceal vessels. No intraoperative complications were reported with the hybrid intracorporeal single port appendectomy or three-port appendectomy. There were two post-operative complications in the group treated with the single port hybrid technique: one intra-abdominal abscess and one surgical site infection. Groups did not differ in age, weight, and types of appendicitis. Operative times were shorter for the hybrid technique (70 vs 79 minutes) but did not differ significantly (P=0.19). This modified technique to a previously described single port extracorporeal appendectomy is easy to master and implement. It provides exposure similar to a three-port laparoscopic appendectomy, while maintaining virtually scarless results and potentially reduces the risk for surgical site infections compared to the extracorporeal technique.http://www.pediatrmedchir.org/index.php/pmc/article/view/133Single portAppendectomyLaparoscopyPolymer clipsPediatrics |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Paul Anthony Karam Amy Hiuser David Magnuson Federico Gian Filippo Seifarth |
spellingShingle |
Paul Anthony Karam Amy Hiuser David Magnuson Federico Gian Filippo Seifarth Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children La Pediatria Medica e Chirurgica Single port Appendectomy Laparoscopy Polymer clips Pediatrics |
author_facet |
Paul Anthony Karam Amy Hiuser David Magnuson Federico Gian Filippo Seifarth |
author_sort |
Paul Anthony Karam |
title |
Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children |
title_short |
Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children |
title_full |
Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children |
title_fullStr |
Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children |
title_full_unstemmed |
Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children |
title_sort |
intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children |
publisher |
PAGEPress Publications |
series |
La Pediatria Medica e Chirurgica |
issn |
0391-5387 2420-7748 |
publishDate |
2016-12-01 |
description |
Transumbilical laparoscopic assisted appendectomy combines laparoscopic single port dissection with open appendectomy after exteriorization of the appendix through the port site. Compared to the conventional three-port approach, this technique provides an alternative with excellent cosmetic outcome. We developed a safe and effective technique to perform an intracorporeal single port appendectomy, using the same laparoscope employed in the extracorporeal procedure. Retrospective review of 71 consecutively performed intracorporeal single port appendectomies and 30 conventional three-port appendectomies in children 6 to 17 years of age. A straight 10-mm Storz telescope with inbuilt 6 mm working channel is used to dissect the appendix, combined with one port-less 2.3 mm percutaneous grasper. Polymer WECK® hem-o-lock® clips are applied to seal the base of the appendix and the appendiceal vessels. No intraoperative complications were reported with the hybrid intracorporeal single port appendectomy or three-port appendectomy. There were two post-operative complications in the group treated with the single port hybrid technique: one intra-abdominal abscess and one surgical site infection. Groups did not differ in age, weight, and types of appendicitis. Operative times were shorter for the hybrid technique (70 vs 79 minutes) but did not differ significantly (P=0.19). This modified technique to a previously described single port extracorporeal appendectomy is easy to master and implement. It provides exposure similar to a three-port laparoscopic appendectomy, while maintaining virtually scarless results and potentially reduces the risk for surgical site infections compared to the extracorporeal technique. |
topic |
Single port Appendectomy Laparoscopy Polymer clips Pediatrics |
url |
http://www.pediatrmedchir.org/index.php/pmc/article/view/133 |
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