Abstract
Purpose: This prospective study evaluated the diagnostic and therapeutic feasibility and safety of microlaparoscopy for the management of chronic abdominal pain in children.
Methods: The study included 45 children (13 boys and 32 girls; age range from 6 to 16 years, average 9.5 years) undergoing diagnostic microlaparoscopy for chronic abdominal pain. Microlaparoscopy (the exclusive use of 2 mm instrument sets and small diameter scopes, i. e. 1.7 mm, 1.9 mm and 2.4 mm) was performed after common organic diseases were ruled out by careful baseline investigations.
Results: No complications occurred which were related to the exclusive use of 2 mm instruments and small scopes. CT scans were avoided in all patients. No intraoperative pathological findings were found in 18 children. In another 18 children, the intraoperative findings indicated the need for further surgical intervention. At follow-up, 26 patients reported that they were totally pain-free; 10 children had partial resolution after surgery, and 8 children reported only minimal resolution. In 20 cases, the procedures were accomplished as an outpatient surgery.
Conclusion: Microlaparosopy seems to be a safe and effective diagnostic tool with a favorable diagnostic accuracy, minimal access trauma and superior cosmesis in children.
Key words
microlaparoscopy - child - abdominal pain - chronic pain - diagnostic laparoscopy
References
-
1
Schneider AR, Benz C, Adamek HE. et al .
Minilaparoscopy versus conventional laparoscopy in the diagnosis of hepatic diseases.
Gastrointest Endosc.
2001;
53
((7))
771-775
-
2
Siegle JC, Bishop LJ, Rayburn WF.
Randomized comparison between two microlaparoscopic techniques for partial salpingectomy.
JSLS.
2005;
9
((1))
30-34
-
3
Shalaby R, Desoky A.
Needlescopic inguinal hernia repair in children.
Pediatr Surg Int.
2002;
18
((2–3))
153-156
-
4
Stringel G, Berezin SH, Bostwick HE. et al .
Laparoscopy in the management of children with chronic recurrent abdominal pain.
JSLS.
1999;
3
((3))
215-219
-
5
Kolts RL, Nelson RS, Park R. et al .
Exploratory laparoscopy for recurrent right lower quadrant pain in a pediatric population.
Pediatr Surg Int.
2006;
22
((3))
247-249
-
6
Roumen RM, Groenendijk RP, Sloots CE. et al .
Randomized clinical trial evaluating elective laparoscopic appendicectomy for chronic right lower-quadrant pain.
Br J Surg.
2008;
95
((2))
169-174
-
7
Morino M, Pellegrino L, Castagna E. et al .
Acute nonspecific abdominal pain: A randomized, controlled trial comparing early laparoscopy versus clinical observation.
Ann Surg.
2006;
244
((6))
881-886
; discussion 886-888.
-
8
Onders RP, Mittendorf EA.
Utility of laparoscopy in chronic abdominal pain.
Surgery.
2003;
134
((4))
549-552
; discussion 552-554
-
9
Salky BA, Edye MB.
The role of laparoscopy in the diagnosis and treatment of abdominal pain syndromes.
Surg Endosc.
1998;
12
((7))
911-914
-
10
Emonts M, Doornewaard H, Admiraal JC.
Adnexal torsion in very young girls: diagnostic pitfalls.
Eur J Obstet Gynecol Reprod Biol.
2004;
116
((2))
207-210
-
11
Schollmeyer T, Soyinka AS, Mabrouk M. et al .
Chronic isolated torsion of the left Fallopian tube: a diagnostic dilemma.
Arch Gynecol Obstet.
2008;
277
((1))
87-90
-
12
Demco L.
Complications of microlaparoscopy and awake laparoscopy.
JSLS.
2003;
7
((2))
141-145
Correspondence
Dr. Salmai TurialMD
University Medical Center
Department of Pediatric
Surgery
Langenbeckstraße 1
55101 Mainz
Germany
Telefon: 49 6131 177 107
Fax: 49 6131 176 523
eMail: turial@ukmainz.de
