ABSTRACT
Objective To evaluate the feasibility of trans-umbilicus two-port laparoscopic procedures in pediatric surgery.Methods Sixty children (age, 3 months～14 years; mean, 3.5 years) with indirect inguinal hernia and 40 children (age, 2.5～14 years; mean, 6.3 years) with appendicitis underwent supra-high ligation and appendectomy, respectively, by using mini laparoscope from January 2003 to December 2003. During the supra-high ligation, the camera and forceps were respectively introduced via the left and right side of umbilical ring, and a hernial-ring needle with suture was brought in at the site of body surface projection of internal ring to apply external knotting. During the appendectomy, laparoscopic instruments were put through the site of right McBurney’s point, and explorations for contralateral hernia or other digestive tract malformations were applied simultaneously. Results All the operations were completed smoothly. The mean operating time was 8.5 min and 55.7 min in hernia repair (per side) and appendectomy, respectively. The mean postoperative hospital stay was 1～2 days in children with indirect inguinal hernia and 5～7 days in children with appendicitis. Follow-up for 3～12 months showed no recurrence of hernia except for 1 case of intraoperatively misdiagnosed latent hernia, which relapsed 2 months after the surgery. Postoperative abdominal cavity infection took place in 2 cases of perforated appendicitis. Conclusions Trans-umbilicus two-port laparoscopic technique is simple to perform, safe and minimally invasive. The technique has fewer complications and gives satisfactory cosmetic results, being highly recommended.