Single-incision laparoscopic splenectomy in children

Abstract

PurposeSingle-incision laparoscopic surgery is being incorporated into the practices of many pediatric surgeons. Its superior cosmetic outcomes have resulted in increased patient- and parent-driven demand for the approach. This article describes a series of single-incision laparoscopic splenectomies (SSs) in children and compares outcomes with a historical series of standard laparoscopic splenectomies (LS). MethodsThe medical records of patients who underwent standard splenectomy and SS at our institution between 2007 and 2010 were reviewed. Perioperative data were recorded. Descriptive comparisons were made between the SS and LS groups. ResultsSeven patients underwent SS, and 4 underwent LS during the study period. Operative times for the SS group decreased as experience with the procedure accumulated and ultimately approached LS operative times. No conversions to a standard laparoscopic or open approach were required. No complications occurred. Length of stay and postoperative pain were similar in both groups. single-incision laparoscopic splenectomy provided excellent cosmetic outcomes. ConclusionsSingle-incision laparoscopic splenectomy is feasible in children. Its main benefit is improved cosmesis. It can be performed without detrimental increases in operative times or patient discomfort. Given an increased demand for the approach, it remains a viable option in children.