Aim of the study
To evaluate the effectiveness and outcomes of the transumbilical approach with glove-port in the treatment of intra-abdominal pathologies in pediatric surgery.
Patients and Methods
Pediatric patients operated on between 2017-2023 using a video-assisted technique with an artisanal glove-port.
Results
A transumbilical wound retractor was placed, with a single port made from a surgical glove and two trocars.
In 15 patients with Hirschsprung’s disease, the intestine was exteriorized for intraoperative biopsy. In 7 cases, additional trocars were used for intracavitary dissection and endoanal pull-through; in 8 cases, ileostomy and deferred pull-through were performed. There was one conversion to laparotomy and no cases of umbilical hernia.
In 12 neonates with intestinal atresia, laparoscopic inspection was performed using the glove-port, followed by exteriorization of the affected intestine, resection, and intestinal anastomosis. Three conversions to laparotomy were noted. A significant reduction in invasive ventilation time was observed (53 vs. 8 hours, p=0.039). Umbilical hernia developed in 16%, with no need for surgery.
In 6 neonates with a prenatal diagnosis of complicated ovarian cyst, exteriorization using the glove-port and cyst drainage was performed, followed by salpingo-oophorectomy with a sealing device.
Of 648 patients with acute appendicitis, 567 (87.5%) were treated exclusively with the glove-port, requiring an additional trocar in 77 cases. Conversion to open surgery was necessary in 21 patients, with no postoperative umbilical hernias.
Conclusions
The glove-port is a safe and efficient technique in pediatric surgery, enabling rapid exteriorization, avoiding repeated trocar insertion, minimizing contamination risks, and ensuring excellent aesthetic outcomes.
Keywords: glove-port, single-port, minimally inavsive surgery, abdominal surgery
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