Pediatric single-incision laparoscopy "virtually scarless"
"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."
New food allergy testing program
This program is a response to requests by allergists to develop a program that will allow testing by the Hospitalist group for these children who, due to risk of anaphylaxis, must be observed for long periods of time. The testing is currently being conducted in Children’s Short Stay Unit by the individual allergists.
For more information on this program, including allergists wishing to take part in the program, please contact
, medical director of Children’s hospitalist program.
Allergists involved in the program:
Thomas Helm, MD
Allergy and Asthma Care
Nancy Ott, MD
Southdale Pediatric Associates
Naveen Sikka, MD
St. Paul Allergy & Asthma
Allan Stillerman, MD
Allergy & Asthma Specialists
Michael Wexler, MD
Advancements in Allergy and Asthma
Craniofacial reconstruction and remodeling part of Cleft and Craniofacial Program expansion
Cleft lip and palate are among the most common birth defects — affecting approximately one in 700 newborns. In response, the Cleft and Craniofacial Program at Children's has expanded its services. The largest growth has been in major craniofacial reconstruction and remodeling for infants and young children.
The evaluation of children diagnosed with craniosynostosis, Aperts and Crouzon's syndromes is overseen by Joe Petronio, MD, and Bob Tibesar, MD, who help lead a multidisciplinary craniofacial team. The team, which includes surgeons, geneticists, nurse practitioners, feeding specialists, oral surgeons, psychologists and social workers, evaluates patients in a collaborative setting.
Patients are evaluated at both the Children's - St. Paul and Children's - Minneapolis campuses, and the plagiocephaly team meets weekly in St. Paul, Minneapolis, and at Children's Minnetonka to evaluate plagiocephaly and institute helmeting protocols.
The evaluation and management of speech disorders in craniofacial and other syndromic patients is another area of recent growth for the program. The care team includes speech pathologists from all campuses and allows for an integrated approach to treating speech abnormalities which involves local providers and Children's specialists.
For more on Children's Cleft and Craniofacial Program, including patient education resources and information on how to refer a patient, go online or call Children's Physician Access, 612-343-2121; 866-755-2121
Children’s and St. Cloud Hospital partner on cancer/blood disorders pediatric care
The partnership helps meet the growing and evolving medical needs of patients and families throughout Central Minnesota by improving access to high quality, family-centered care for kids fighting cancer and blood disorders. It formalizes a 10-year relationship between St. Cloud Hospital and Children’s and allows both organizations to builds upon the success of a collaborative care model. Already the new partnership has helped St. Cloud Hospital form a Pediatric Sedation Program this past spring, and talks are underway to expand the relationship into neurosciences within the next year.