Experience of Single-Incision Laparoscopic Reduction of Intussusceptions: Comparison With Conventional Laparoscopic Reduction

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  • Owari Mitsugu
    Department of Pediatric Surgery, Nara Hospital, Kinki University School of Medicine Department of Pediatric Surgery, Osaka University Graduated School of Medicine
  • Yamauchi Katsuji
    Department of Pediatric Surgery, Nara Hospital, Kinki University School of Medicine
  • Kamiyama Masafumi
    Department of Pediatric Surgery, Nara Hospital, Kinki University School of Medicine
  • Morisita Yuji
    Department of Pediatric Surgery, Nara Hospital, Kinki University School of Medicine
  • Yonekura Takeo
    Department of Pediatric Surgery, Nara Hospital, Kinki University School of Medicine

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Other Title
  • 小児腸重積症に対する単孔式腹腔鏡下整復術の有用性
  • 小児腸重積症に対する単孔式腹腔鏡下整復術の有用性 : 従来の腹腔鏡下整復術との比較検討
  • ショウニ チョウジュウ セキショウ ニ タイスル タンコウシキ フククウキョウ カ セイフクジュツ ノ ユウヨウセイ : ジュウライ ノ フククウキョウ カ セイフクジュツ ト ノ ヒカク ケントウ
  • ―従来の腹腔鏡下整復術との比較検討―

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Abstract

Purpose: We evaluated the safety and validity of a single-incision laparoscopic procedure (SILP) in comparison with a conventional laparoscopic procedure (CLP) for reduction of intestinal intussusception in children.<br>Methods: Between October 1999 and January 2013, 21 cases underwent laparoscopic reduction; and where 15 cases were treated using a three-port procedure (CLP), and 6 cases using SILP. We reviewed retrospectively the age of patients, length of the afflicted time, operation time, oral intake resumption, and period of hospitalization between the two groups.<br>Results: Lengths of the afflicted time of CLP and SILP were 28.3 ± 76.0 and 39.0 ± 32.8 hours, respectively. The operation time was 116.9 ± 62.9 minutes for CLP and 113.2 ± 70.8 minutes for SILP. Associated lesions occurred in 3 cases with CLP (Meckel diverticulum, ileal enteric duplication, and an enteric cyst of the ileum), while with SILP, there was one case of ileocecal enteric duplication. The associated lesions of 3 CLP cases were extracted through the expanded umbilical wound, and resected under direct vision. A SILP case was treated by removing the EZ accessTM and extracting the ileocecal duplication with the Lap ProtectorTM, and ileocecal resection under direct vision. Post-surgical observations revealed that the time taken for resuming oral ingestion was 3.3 ± 2.6 days in CLP cases, and 3.3 ± 1.8 days in SILP cases, demonstrating no significant difference between groups. The period of hospitalization was 7.8 ± 2.7 days for CLP and 7.5 ± 1.9 days for SILP cases.<br>Conclusions: Single-incision surgery offers excellent cosmetic benefits, and establishes outcome levels similar to conventional surgery.

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