Pediatric single-incision laparoscopy "virtually scarless"

SILS"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."