"When laparoscopy was first used in pediatrics, parents would marvel that their child's surgery was done using only very small incisions," said David Wahoff, MD, PhD, a surgeon with Pediatric Surgical Associates and a Children's professional staff member. "But now, with single-incision laparoscopy, there's really no visible scar. Parents just can't believe it's virtually scarless."
While single-incision laparoscopy has been conducted for more than a decade on adult patients, it only recently has been performed on pediatric patients.
Wahoff is one of only a handful of surgeons in the Twin Cities to perform single-incision laparoscopic procedures on pediatric patients.
Because single-incision laparoscopy involves only a small incision through a patient's umbilicus, the procedure is as close to a scarless procedure as there exists today.
How it works
- The procedure uses specialized instrumentation, including a port, which facilitates the insertion of three cannulae through which instruments are passed.
- The instruments work together to provide surgeons with 360-degree rotation and hand-like access to a patient's abdomen.
- The port also features a valve that allows surgeons to inflate the abdomen for optimal instrument access.
Advantages over open surgery
- greatly reduced pain and scar tissue
- a faster recovery
- much lower incidence of infection
Advantages over multi-point laparoscopy
- less pain for patients
- virtually no scarring
- minimal recovery time
"A real paradigm shift"
The three most common pediatric procedures that single-incision laparoscopy is used for are cholecystectomies, appendectomies and intestinal resections, often in instances of Crohn's disease.
In adults, the procedure has been used to treat an ever-growing list of complex gynecologic, urologic and colorectal conditions. Wahoff believes the procedure’s use in pediatric patients will follow a similar course.
"As we move forward, I think most pediatric procedures will at least be attempted through a single site and expanded to a multi-site laparoscopy only if the situation warrants," said Wahoff, who has performed laparoscopic procedures on children for more than 12 years.
"It represents a continued movement toward minimally invasive techniques — a real paradigm shift."