PMID- 20379949
OWN - NLM
STAT- MEDLINE
DCOM- 20100802
LR  - 20171116
IS  - 1438-9592 (Electronic)
IS  - 0044-409X (Linking)
VI  - 135
IP  - 2
DP  - 2010 Apr
TI  - [Laparoendoscopic single site cholecystectomy (LESS) in a 16-year-old girl: the 
      way to go even in pediatric surgery?].
PG  - 188-9
LID - 10.1055/s-0029-1224683 [doi]
AB  - The laparoscopic paradigm to place different ports according to ergonomic 
      principles is presently challenged by laparoendoscopic single site surgery 
      (LESS). Its objective is to perform a complex task with several instruments using 
      only one access. However, this approach introduces distinct ergonomic problems 
      and requires innovative technical solutions to allow for more complex surgical 
      tasks. In paediatric surgery, this development has just begun. A 16-year-old girl 
      presented with a symptomatic cholecystolithiasis. A multi-channel TriPort 
      (Advanced Surgical Concepts) was introduced through a 20 mm umbilical incision 
      for LESS cholecystectomy. Retraction of the gallbladder was facilitated by a 
      straight grasper, which was inserted transabdominally. For exposition and 
      triangulation a pre-bend dissector (5 mm, Olympus) was employed. Thus, the cystic 
      duct and artery could be exposed, clipped (5mm) and divided. Finally, the 
      gallbladder was dissected from its bed and extracted into a specimen bag. 
      Operating time was 90 minutes and no intra- or postoperative complications 
      occurred. In conclusion, a multi-channel port and angulated instruments during 
      LESS cholecystectomy provided ergonomics close to conventional laparoscopic 
      surgery. For smaller children though, this technology will have to be adapted to 
      their geometry. Finally, even though LESS seems attractive, the present euphoria 
      should not turn into scientific acceptance, until more experience is available 
      and valid data have proven a benefit for patients of any age.
FAU - Till, H
AU  - Till H
AD  - Universitatsklinikum Leipzig AOR, Klinik und Poliklinik fur Kinderchirurgie, 
      Leipzig, Germany.
FAU - Wachowiak, R
AU  - Wachowiak R
FAU - Marinoni, F
AU  - Marinoni F
FAU - Buhligen, U
AU  - Buhligen U
FAU - Stolzenburg, J-U
AU  - Stolzenburg JU
LA  - ger
PT  - Case Reports
PT  - Journal Article
TT  - Laparoendoskopische Single-Site-Cholezystektomie (LESS) bei einem 16-jahrigen 
      Madchen: Ein Weg auch fur die Kinderchirurgie?
DEP - 20100408
PL  - Germany
TA  - Zentralbl Chir
JT  - Zentralblatt fur Chirurgie
JID - 0413645
SB  - IM
MH  - Adolescent
MH  - Cholecystectomy, Laparoscopic/*instrumentation
MH  - Equipment Design
MH  - Ergonomics
MH  - Female
MH  - Gallstones/*surgery
MH  - Humans
MH  - Laparoscopes
MH  - Minimally Invasive Surgical Procedures/*instrumentation
MH  - Surgical Instruments
EDAT- 2010/04/10 06:00
MHDA- 2010/08/03 06:00
CRDT- 2010/04/10 06:00
PHST- 2010/04/10 06:00 [entrez]
PHST- 2010/04/10 06:00 [pubmed]
PHST- 2010/08/03 06:00 [medline]
AID - 10.1055/s-0029-1224683 [doi]
PST - ppublish
SO  - Zentralbl Chir. 2010 Apr;135(2):188-9. doi: 10.1055/s-0029-1224683. Epub 2010 Apr 
      8.