The international experience of single-incision pediatric endosurgery: current state of the art.

Journal Article (Review;Journal Article)

Purpose

As application and awareness of single-incision pediatric endosurgery (SIPES) are increasing, various techniques and indications have been independently described by select centers around the world. In order to facilitate a cooperative approach toward advancing and investigating the practice of SIPES, we conducted a survey among members of the International Pediatric Endosurgery Group (IPEG), asking them about their experience and attitudes toward single-incision endosurgery.

Materials and methods

After institutional review board approval, an invitation to participate in an online survey was sent to all IPEG members. Questions focused on demographic information, practice patterns, indications, and equipment used regarding SIPES.

Results

Of the 560 contacted active IPEG members, 115 completed the survey (recall 21%). The respondents represented pediatric surgeons from 32 countries on six continents. Of respondents, 97% had heard of, while 71% had performed, SIPES. Reasons for not having performed SIPES included disbelief in benefit (59%), lack of proficiency (34%), and inadequate resources (28%). The most commonly performed SIPES procedures were appendectomy (85%), cholecystectomy (66%), splenectomy (42%), pyloromyotomy (35%), and intestinal surgery (13%), as well as Nissen fundoplication and gynecologic adnexal pathology (7%). The equipment and techniques utilized showed large variation and included some self-devised, innovative, low-resource approaches. Complications with SIPES reported by the survey participants included technical difficulties, wound infection, and prolonged operating time.

Conclusions

SIPES is being performed worldwide for a large spectrum of common indications in pediatric surgery. The equipment and techniques used vary with geographic location and resources. Some encountered complications are common to those seen with conventional minimally invasive surgery, whereas others may be SIPES-specific. Different respondents reported diverging views on pain, operating time, and cost.

Full Text

Duke Authors

Cited Authors

  • Rich, BS; Creasy, J; Afaneh, C; Muensterer, OJ

Published Date

  • January 2014

Published In

Volume / Issue

  • 24 / 1

Start / End Page

  • 43 - 49

PubMed ID

  • 24147902

Pubmed Central ID

  • 24147902

Electronic International Standard Serial Number (EISSN)

  • 1557-9034

International Standard Serial Number (ISSN)

  • 1092-6429

Digital Object Identifier (DOI)

  • 10.1089/lap.2013.0294

Language

  • eng