Single-incision pediatric Endosurgical (SIPES) versus conventional laparoscopic pyloromyotomy: a single-surgeon experience

Abstract

Background: Pyloromyotomy by single-incision pediatric endosurgery (SIPES) is a new technique that leaves virtually no appreciable scar. So far, it has not been compared to conventional laparoscopic (CL) pyloromyotomy. This study compares the results of the first 15 SIPES pyloromyotomies of a surgeon to his last 15 CL cases.

Methods: Data were collected on all SIPES pyloromyotomies. Age, gender, operative time, estimated blood loss, conversion/complication rate, and outcome in the SIPES patients were compared to the CL cohort.

Results: There was no difference in age, weight, gender, blood loss, or hospital stay. A trend toward shorter operating time was found in the CL group (21.7 +/- 9.9 versus 30.3 +/- 15.8, p = 0.08, 95%CI 20.9-39.7 min). Two mucosal perforations occurred in the SIPES cohort. Both cases were converted to conventional laparoscopy, the defect was repaired, and both patients had an uncomplicated postoperative course. There were no wound infections or conversions to open surgery. Parents were uniformly pleased with the cosmetic results of SIPES.

Conclusion: SIPES pyloromyotomy may have a higher perforation rate than the CL approach. If recognized, a laparoscopic repair is feasible. Improved cosmesis must be carefully weighed against the potentially increased risks of SIPES versus conventional laparoscopic pyloromyotomy.