Abstract | BACKGROUND: OBJECTIVE: To describe our initial experience with single-incision laparoscopic pyloromyotomy in 15 infants. MATERIALS AND METHODS: Laparoscopic pyloromyotomy was performed through a single skin incision in the umbilicus, using a 4-mm 30 degrees endoscope and a 5-mm trocar. The 3-mm working instruments were inserted directly into the abdomen via separate lateral fascial stab incisions. All patients were prospectively evaluated. RESULTS: The procedure was performed in 15 infants (13 male) with mean age of 45 +/- 16 days and mean weight of 4.04 +/- 0.5 kg. All procedures were completed laparoscopically, and one case was converted to a conventional triangulated laparoscopic work configuration after a mucosal perforation was noted. The perforation was repaired laparoscopically. On average, operating time was 29.8 +/- 13.6 min, and postoperative length of stay was 1.5 +/- 0.8 days. All patients were discharged home on full feeds. Follow-up was scheduled 2-3 weeks after discharge, and no postoperative complications were noted in any of the patients. CONCLUSIONS: Single-incision laparoscopic pyloromyotomy is a safe and feasible procedure with good postoperative results and excellent cosmesis. The main challenge is the spatial orientation of the instruments and endoscope in a small working space. This can be overcome by a more longitudinally oriented working axis than used in the conventional angulated laparoscopic configuration.
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Authors | Oliver J Muensterer, Obinna O Adibe, Carrol M Harmon, Albert Chong, Erik N Hansen, Donna Bartle, Keith E Georgeson |
Journal | Surgical endoscopy
(Surg Endosc)
Vol. 24
Issue 7
Pg. 1589-93
(Jul 2010)
ISSN: 1432-2218 [Electronic] Germany |
PMID | 20033707
(Publication Type: Journal Article)
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Topics |
- Female
- Humans
- Infant
- Infant, Newborn
- Laparoscopy
(methods)
- Male
- Pyloric Stenosis, Hypertrophic
(surgery)
- Pylorus
(surgery)
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