20 Years of Single-Incision-Pediatric-Endoscopic-Surgery: A Survey on Opinion and Experience Among International Pediatric Endosurgery Group Members

J Laparoendosc Adv Surg Tech A. 2021 Mar;31(3):348-354. doi: 10.1089/lap.2020.0797. Epub 2020 Dec 31.

Abstract

Aim/Background: Assessment of current role and future trends of Single-Incision-Pediatric-Endoscopic-Surgery (SIPES) in pediatric surgery among International Pediatric Endosurgery Group (IPEG) members two decades after introduction. Materials and Methods: An online survey was conducted between December 2019 and April 2020 on behalf of the IPEG Research Committee. All IPEG members were contacted by e-mail and asked to complete an anonymous questionnaire that included 39 items on SIPES. Results: One hundred eighty-four practicing pediatric surgeons completed the questionnaire from a pool of 890 IPEG members. The majority (76%) of respondents performed SIPES for more than 6 years with the following caseload per month: 1 case (31%), 2-5 cases (30%), 6-10 cases (24%), and >10 cases (17%). The four most commonly performed procedures were appendectomy (95%), Meckel diverticulectomy (55%), treatment of ovarian pathologies (43%), and U-stitch gastrostomy (40%). Complex reconstructive SIPES procedures were performed rarely. Most surgeons (95%) stated that better cosmesis is the predominant advantage of SIPES procedures. The majority of respondents (70%) felt that there is no convincing scientific evidence that SIPES offers benefits to multi-port minimally invasive procedures. Conclusion: Twenty years after introduction of SIPES, this technique has found its place in pediatric endoscopic surgery. Eighty percent of participating IPEG members of this survey apply SIPES for cases of lower complexity, such as appendectomy mainly for cosmetic reasons. The fact that 70% of respondents state that the scientific evidence for the benefits of SIPES is not convincing suggests that further studies and discussion on this technique are needed.

Keywords: IPEG; SIPES; pediatric minimally invasive surgery; single-incision-surgery; single-site-surgery.

MeSH terms

  • Adult
  • Appendectomy / methods
  • Endoscopy / methods
  • Endoscopy / statistics & numerical data*
  • Female
  • Gastrostomy / methods
  • Humans
  • Meckel Diverticulum / surgery
  • Middle Aged
  • Operative Time
  • Ovarian Diseases / surgery
  • Pediatrics / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Specialties, Surgical / statistics & numerical data*
  • Surgeons / statistics & numerical data*
  • Surveys and Questionnaires