Cholecystectomy from single laparoscopic access in children. To be or not to be?

Abstract

Relevance. The progress of achievements in surgery is associated with the desire to perform an operation less traumatic and with the best cosmetic effect. These requirements are met by laparoscopic surgery of one access SPLS (Single Port Laparoscopic Surgery). The aim of research. Improve the results of treatment of children with calculous cholecystitis Materials and methods. For the period from February 2012 to March 2017, under our supervision, there were 36 patients with calculous cholecystitis. Operation to remove the gallbladder was performed using U-NOTES (umbilical natural orifice transumbilican endoscopic surgery). We used a special reusable X-CONE TM port from Karl Storz, a three-chip HD camera with elongated optics. Cholecitectomy was performed standardly with clumping of the vesicular duct and clumping or coagulation of the vesicle artery. The operation is mainly performed from the cervix. In the presence of infiltration or the appearance of complications with the allocation of cells in 3 patients cholecystectomy was carried out from the bottom. In 5 patients at the stage of “working out” of the cystic duct and artery, an additional 3 mm port was required. The duration of the operation was 43 ± 9.8 minutes. Antibiotic therapy was performed in one injection 30 minutes before the start. Anesthesia patients required only during the first day after the intervention. There were no complications in the postoperative period. Especially it is possible to note ease of extraction of a cholic bubble from an abdominal cavity through a monoport. Conclusions. Can be noted that the duration of the operation and the course of the postoperative period, with the use of a single laparoscopic access through the navel, is comparable to classical laparoscopy. Cosmetic effect after operations from a single laparoscopic approach is assessed by patients above. This leads to an improvement in their quality of life.