Single-site laparoscopic appendectomy in children using conventional instruments: a prospective, randomized, control trial

Wu, Kai; Lü, Yang; Wu, Aiguo; Wang, Jianjun; Xu, Shuai; Zhao, Haijun; Huang, Zong-hai

doi:10.1007/s00383-014-3636-1

Cited by 24 publications

(3 citation statements)

References 22 publications

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“…The MOT of SIPESA undertaken by our resident is not signi cantly longer than CLA as reported in other publications 16,17,18,19,20,21,22,23 . This may be explained by techniques we developed to overcome instrument collision such as changing the placement of instruments in the SILS port, rotating the port clockwise and anticlockwise depending on the direction of traction of the appendix.…”

Section: Resultssupporting

confidence: 73%

Residents' Performance of Single-Incision Pediatric Endo-Surgery Appendectomy (SIPESA) Versus Conventional Laparoscopic Appendectomy (CLA) in Two Centers

Raboe

Owiwi

Ghallab

et al. 2020

Preprint

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Background: The outcome of SIPESA performed by surgical residents is explored once in the literature. To the best of our knowledge, there are no published studies comparing the outcome of SIPESA versus CLA performed by the surgical residents.Aim: To assess the outcome of SIPESA at King Fahd Armed Forces Hospital (KFAFH), Jeddah versus CLA at Prince Sultan Military Medical City (PSMMC), Riyadh performed by surgical residents. Material & Methods: A retrospective comparative study of the outcome of SIPESA versus CLA conducted in two centers from January 2011 to July 2018. The two groups were compared for age, seniority of operating surgeon, mean operative time (MOT), perioperative complications and length of hospital stay (LOS).Results: 136 appendectomies (83(61%) SIPESA & 53(39%) CLA) were performed by residents between January 2011 and July 2018 in both centers. Postoperative complications were reported in 3.8% of CLA and 3.6% of SIPESA. There was no significant difference in postoperative complications between the two groups. The MOT of SIPESA and CLA was 92.25 minutes & 87.85 minutes respectively. Conclusion: SIPESA and CLA performed by residents are equally safe and feasible with no added morbidity. We believe that this good outcome is related to the adequate supervision of residents by experienced surgeons in conjunction with a properly structured training program. There was no significant difference in the outcome of both groups.

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Section: Resultssupporting

confidence: 73%

Residents' Performance of Single-Incision Pediatric Endo-Surgery Appendectomy (SIPESA) Versus Conventional Laparoscopic Appendectomy (CLA) in Two Centers

Raboe

Owiwi

Ghallab

et al. 2020

Preprint

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“…15,16 Frutos et al, contrary to our results inferred that the operative duration was marginally longer in SILA (p=0.02), and less pain post op (p≤0.001). 17 These findings suggest that the post op pain scores in SILA in all these studies have been variable, which could be attributed to the heterogeneous methodology of pain assessment. A standard pain scale and post op analgesic administration is required to accurately assess these outcomes.…”

Section: Discussionmentioning

confidence: 86%

Single incision laparoscopic appendicectomy versus conventional laparoscopic appendicectomy- a prospective study

2017

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Background: The advent of Single incision laparoscopic appendicectomy (SILA) has encouraged surgeons to compare its benefits over conventional laparoscopic appendicectomy (CLA). We conducted a prospective study comparing SILA with CLA, evaluating parameters like operative time and complications, post-operative pain, duration of stay and the cosmetic outcome.Methods: A prospective, comparative study of 94 consecutive patients was conducted at our institution between December 2014 and May 2016. The data regarding the various parameters were documented in both groups of patients.Results: Among the 94 patients, 30 underwent SILA and 64 underwent CLA. We found statistically significant outcomes for SILA over CLA in variables such as operative time (p=0.0018), duration of hospital stay (p≤0.0001) and cosmetic outcome (p≤0.0001). Almost all patients in the SILA category showed no evidence of a scar after a three month follow up.Conclusions: SILA was found to have a better outcome than CLA with regard to operative time, hospital stay and cosmesis. We conclude that this technique of SILA can be a better alternative to CLA.

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“…There was no difference in duration of hospital stay or postoperative complications. Longer MOT with SIPES appendectomy was the main concern [11, [30][31][32][33][34][35][36][37][38][39][40][41]. One study has shown that SIPES appendectomy in children is safe and feasible when performed by resident doctors and compare it when performed by fellows [42].…”

Section: Sipes Appendectomymentioning

confidence: 99%

Single-Incision Pediatric Endosurgery (SIPES)

Raboei¹,

Alsaggaf²,

Owiwi³

et al. 2019

Pediatric Surgery, Flowcharts and Clinical Algorithms

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Most centers advocate laparoscopy in order to minimize the size and the number of skin incisions. Many comparative studies, systematic review, and pooled analysis demonstrate that single-incision laparoscopic surgery (SILS) is comparable to conventional laparoscopic surgery (CLS). However, this review identifies the need for randomized controlled trials to clarify the efficacy of SIPS compared with CLS. SIPES pediatric has gained significant popularity. Longer M OT with SIPES was the main concern in most published series. One study has shown that SIPES in children is safe and feasible when performed by resident doctors in comparison to the fellow. We started SIPES in 2003. It is carried out routinely by trainees and specialists. Interferences and collisions between surgical instruments are worse in SIPES than CLS. These challenges extended the OT. Although the use of flexible laparoscopic instruments instead of straight instruments may overcome these technical difficulties, only straight laparoscopic instruments are currently used in our institution. Our aim is to standardize this approach in pediatric age group. The technique can be imparted satisfactorily to trainees. However, its successful incorporation into surgical training programs will depend on the development of innovative simulation strategies.2 appeared in 1992 with appendectomies [4]. In the same year, D'Alessio described a technique for appendectomy in pediatric patients in which a special port was used at the umbilicus to allow the surgeon to bring the appendix out through the umbilicus to perform an extracorporeal appendectomy [5]. 19% of 166 patients in their series required additional trocars, and 4% required conversion to an open operation. The MOT (MOT) was 35 min with a 7-day return to normal activity, compared with 10 days for those that required additional trocars. SIPES has been introduced in our institute by 2003. Now SIPES is our standard technique for many procedures like cholecystectomy, splenectomy, appendectomy, assisted Mitrofanoff, SIPES hernia repair percutaneous internal ring suturing (PIRS), ovarian cystectomy, and fundoplication since 2011. We have performed around 400 SIPES cases up-to-date.

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Single-site laparoscopic appendectomy in children using conventional instruments: a prospective, randomized, control trial

Abstract: The findings of this study demonstrate that using conventional instruments to perform SSLS is technically feasible and safe in children. Although SSLS appendectomy does increase the operative time, it does not increase the complication rate and hospital cost.

Cited by 24 publications

References 22 publications

Residents' Performance of Single-Incision Pediatric Endo-Surgery Appendectomy (SIPESA) Versus Conventional Laparoscopic Appendectomy (CLA) in Two Centers

Residents' Performance of Single-Incision Pediatric Endo-Surgery Appendectomy (SIPESA) Versus Conventional Laparoscopic Appendectomy (CLA) in Two Centers

Single incision laparoscopic appendicectomy versus conventional laparoscopic appendicectomy- a prospective study

Single-Incision Pediatric Endosurgery (SIPES)

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