Single incision laparoscopic surgery cholecystectomy in children – preliminary experience

Introduction : Laparoscopic cholecystectomy has become the gold standard for cholecystectomy, since Mouret introduced it in 1987. In 1997 Navarra described “one incision” cholecystectomy, but only recently has single incision laparoscopic surgery (SILS) gained wider acceptance, mostly due to technological developments. The primary goals of SILS are avoidance of visible scarring and minimizing surgical trauma.

Aim : We present our first experience of 3 cases of children (2 females, 1 male; ages 2.5-17 years) treated with SILS cholecystectomy.

Methods and results : One child had undergone previous open left adrenalectomy for neuroblastoma. We used a Covidien SILS Port in one case and 3 single-use low-profile ports in the others. Percutaneous stay suture was used to suspend the gallbladder, and standard cholecystectomy was performed using 1 straight and 1 disposable articulating instrument. There were no postoperative complications. Average operating time was 70 min. Hospital stay varied from 2 to 4 days.

Conclusion : Our early experience with SILS cholecystectomy in children suggests that it is safe and effective, but further studies and greater numbers will be required to investigate the potential benefits of this approach.