Portal de Periódicos da CAPES

Hidden Incision Endoscopic Surgery: Description of Technique, Parental Satisfaction and Applications

2011; Lippincott Williams & Wilkins; Volume: 185; Issue: 4 Linguagem: Inglês

10.1016/j.juro.2010.11.054

1527-3792

Patricio C. Gargollo,

Intestinal Malrotation and Obstruction Disorders

No AccessJournal of UrologyPediatric Urology1 Apr 2011Hidden Incision Endoscopic Surgery: Description of Technique, Parental Satisfaction and Applications Patricio C. Gargollo Patricio C. GargolloPatricio C. Gargollo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.11.054AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The advantages of minimally invasive surgery over open surgery in pediatrics include smaller incisions, decreased postoperative pain, reduced postoperative narcotic use, faster return to normal activity and decreased length of hospitalization. However, minimally invasive surgery with its traditional port placement leads to visible scars. To eliminate scarring, we have developed HIdESSM, or hidden incision endoscopic surgery. Materials and Methods: For this technique a robotic working port, camera port and 5 mm assistant port are placed below the line of a Pfannenstiel incision. The second working 8 or 5 mm port is placed infraumbilically. The procedure is then carried out depending on the nature of the case. For this study operative times were recorded. Patients who underwent HIdES pyeloplasty or nephrectomy and their parents were asked to compare the cosmetic outcome of the trocar incisions to pictures of patients who had undergone laparoscopic surgery (pyeloplasty or nephrectomy) with traditional port placement and open surgery using validated wound and scar evaluation scales. Results: HIdES was used in 12 cases. No complications were encountered. When comparing all 3 questionnaire results for each technique used, parents and patients were statistically more satisfied with the cosmetic results after HIdES than traditional laparoscopic or open operation. Conclusions: The HIdES technique allows all port sites to be hidden at the level of a Pfannenstiel incision, and thus renders them nonvisible if the patient is wearing a bathing suit. This approach is preferred by patients and parents alike. References 1 : Comparison of flank, dorsal lumbotomy and laparoscopic approaches for dismembered pyeloplasty in children older than 3 years with ureteropelvic junction obstruction. J Urol2010; 183: 306. Link, Google Scholar 2 : Pediatric robot assisted laparoscopic dismembered pyeloplasty: comparison with a cohort of open surgery. J Urol2006; 175: 683. Link, Google Scholar 3 : Laparoscopic versus open pyeloplasty: comparison of two surgical approaches—a single centre experience of three years. J Minim Access Surg2008; 4: 76. Google Scholar 4 : Parental satisfaction after open versus robot assisted laparoscopic pyeloplasty: results from modified Glasgow Children's Benefit Inventory Survey. J Urol2010; 183: 704. Link, Google Scholar 5 : Robotic-assisted laparoscopic surgery in pediatric urology: an update. Scand J Surg2009; 98: 110. Google Scholar 6 : Robotic-assisted surgery in children: advantages and limitations. J Robot Surg2010; 4: 19. Google Scholar 7 : Technical considerations and feasibility of pediatric laparo-endoscopic single site (LESS) nephrectomies. J Urol2010; 183: e179. abstract 454. Link, Google Scholar 8 : The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg2004; 113: 1960. Google Scholar 9 : Wound registry: development and validation. Ann Emerg Med1995; 25: 675. Google Scholar 10 : A new quantitative scale for clinical scar assessment. Plast Reconstr Surg1998; 102: 1954. Google Scholar 11 : Radionuclide investigations of the urinary tract in the era of multimodality imaging. J Nucl Med2006; 47: 1819. Google Scholar 12 : Systematic review and meta-analysis of robotic-assisted versus conventional laparoscopic pyeloplasty for patients with ureteropelvic junction obstruction: effect on operative time, length of hospital stay, postoperative complications, and success rate. Eur Urol2009; 56: 848. Google Scholar 13 : Nerve sparing robotic extravesical ureteral reimplantation. J Urol2008; 179: 1987. Link, Google Scholar 14 : A comparison of open vs laparoscopic pediatric pyeloplasty using the pediatric health information system database—do benefits of laparoscopic approach recede at younger ages?. J Urol2008; 180: 1479. Link, Google Scholar 15 : Straight-arm positioning and port placement for robotic-assisted laparoscopic renal surgery. J Robot Surg2010; 4: 29. Google Scholar 16 : Concurrent management of bilateral ureteropelvic junction obstruction in children using robotic-assisted laparoscopic surgery. Int Braz J Urol2008; 34: 198. Google Scholar 17 : The minimally invasive open pyeloplasty. J Pediatr Urol2006; 2: 368. Google Scholar 18 : Single incision miniature pyeloplasty and ipsilateral inguinal herniorrhaphy in infants. J Urol2010; 183: 1545. Link, Google Scholar 19 : Incisions do not simply sum. Surg Endosc2010; 24: 1746. Google Scholar 20 : Analysis of the collagen content and tensile strength of the aponeurotic scar—an experimental study in pigs. Eur J Plast Surg1999; 22: 28. Google Scholar 21 : Early experience with single-port laparoscopic surgery in children. J Laparoendosc Adv Surg Tech A2009; 19: 551. Google Scholar 22 : Robotic single-site surgery. Curr Opin Urol2010; 20: 86. Google Scholar 23 : Current limitations and perspectives in single port surgery: pros and cons laparo-endoscopic single-site surgery (LESS) for renal surgery. Diagn Ther Endosc2010; 2010: 759431. Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byBayne C and Smith J (2023) Early Experience With Pediatric Single-port Robotic Pyeloplasty Compared to Multiport Robotic Cohorts. Reply.Journal of Urology, VOL. 210, NO. 5, (733-733), Online publication date: 1-Nov-2023.Smith J, Hernandez A, DeMarco R and Bayne C (2023) Early Experience With Pediatric Single-port Robotic Pyeloplasty Compared to Multiport Robotic CohortsJournal of Urology, VOL. 210, NO. 2, (236-238), Online publication date: 1-Aug-2023.DaJusta D (2022) Incision Looks, to Whom It May Concern: Parents, Patient or Surgeon?Journal of Urology, VOL. 207, NO. 5, (954-955), Online publication date: 1-May-2022.Liu D (2022) Editorial CommentJournal of Urology, VOL. 207, NO. 5, (1125-1126), Online publication date: 1-May-2022.Bayne C (2022) Editorial CommentJournal of Urology, VOL. 207, NO. 5, (1125-1125), Online publication date: 1-May-2022.Ghidini F, Bortot G, Gnech M, Contini G, Escolino M, Esposito C, Capozza N, Berrettini A, Masieri L and Castagnetti M (2021) Comparison of Cosmetic Results in Children >10 Years Old Undergoing Open, Laparoscopic or Robotic-Assisted Pyeloplasty: A Multicentric StudyJournal of Urology, VOL. 207, NO. 5, (1118-1126), Online publication date: 1-May-2022.Rague J, Arora H, Chu D, Shannon R, Rosoklija I, Johnson E, Gong E and Lindgren B (2021) Safety and Efficacy of Robot-Assisted Laparoscopic Pyeloplasty Compared to Open Repair in Infants under 1 Year of AgeJournal of Urology, VOL. 207, NO. 2, (432-440), Online publication date: 1-Feb-2022.Jacoby A, Maliha S, Granieri M, Cohen O, Dy G, Bluebond-Langner R and Zhao L (2019) Robotic Davydov Peritoneal Flap Vaginoplasty for Augmentation of Vaginal Depth in Feminizing VaginoplastyJournal of Urology, VOL. 201, NO. 6, (1171-1176), Online publication date: 1-Jun-2019.Jacobson D, Shannon R, Johnson E, Gong E, Liu D, Flink C, Meyer T, Cheng E and Lindgren B (2019) Robot-Assisted Laparoscopic Reoperative Repair for Failed Pyeloplasty in Children: An Updated SeriesJournal of Urology, VOL. 201, NO. 5, (1005-1011), Online publication date: 1-May-2019.Garcia-Roig M, Travers C, McCracken C, Cerwinka W, Kirsch J and Kirsch A (2016) Surgical Scar Location Preference for Pediatric Kidney and Pelvic Surgery: A Crowdsourced SurveyJournal of Urology, VOL. 197, NO. 3 Part 2, (911-919), Online publication date: 1-Mar-2017.Grimsby G, Jacobs M, Menon V, Schlomer B and Gargollo P (2015) Perioperative and Short-Term Outcomes of Robotic vs Open Bladder Neck Procedures for Neurogenic IncontinenceJournal of Urology, VOL. 195, NO. 4 Part 1, (1088-1092), Online publication date: 1-Apr-2016.Grimsby G, Dwyer M, Jacobs M, Ost M, Schneck F, Cannon G and Gargollo P (2014) Multi-Institutional Review of Outcomes of Robot-Assisted Laparoscopic Extravesical Ureteral ReimplantationJournal of Urology, VOL. 193, NO. 5S, (1791-1795), Online publication date: 1-May-2015.Barbosa J, Barayan G, Gridley C, Sanchez D, Passerotti C, Houck C and Nguyen H (2013) Parent and Patient Perceptions of Robotic vs Open Urological Surgery Scars in ChildrenJournal of Urology, VOL. 190, NO. 1, (244-250), Online publication date: 1-Jul-2013. Volume 185Issue 4April 2011Page: 1425-1431 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordscicatrixlaparoscopypediatricsroboticsurologic surgical proceduresMetrics Author Information Patricio C. Gargollo More articles by this author Expand All Advertisement PDF downloadLoading ...