Technical Report on the Initial Cases of Single-Incision Laparoscopic Combined Cholecystectomy and Splenectomy in Children, Using Conventional Instruments

Aim. The authors report a technique to perform single-incision laparoscopic combined cholecystectomy and splenectomy in 3 children using conventional instruments. Methods . Three ports, including 5-mm and 3-mm ports, were placed through an infraumbilical incision for the procedure. Splenectomy was completed in most parts by crossing the 2 straight instruments. Results. The 3 patients, aged 11 to 13 years, with body weight 29 kg to 32 kg, underwent the procedure. In the first patient, 2 additional extraumbilical 5-mm ports were required to complete the splenectomy. After modification of the technique, combined cholecystectomy and splenectomy by SILS were successfully performed in the other 2 patients without complications, and postoperative courses were uneventful. Conclusions. Combined cholecystectomy and splenectomy in children by SILS is technically feasible using conventional instruments. Further studies are required to investigate its safety, benefits over conventional laparoscopic surgery, and refinements in the technique.