Five-year experience with optical balloon port for retroperitoneal access in children

• Published in: Journal of pediatric endoscopic surgery Vol. 3; no. 4; pp. 211 - 214
• Main Authors: De Silva, L. A. K., Hennayake, S., Goyal, A., Keene, D., Cserni, T.
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01-12-2021
• Subjects: Abdominal Surgery; Medicine; Medicine & Public Health; Minimally Invasive Surgery; Original Research; Pediatric Surgery; Surgery; Thoracic Surgery; Laparoscopic surgery; Optical trocar; Balloon port; Retroperitoneal
• ISSN: 2524-7875; 2524-7883
• DOI: 10.1007/s42804-021-00118-5

Introduction
Optical balloon ports offer quick, easy and well controlled retroperitoneal access. However, the relatively long tip of the port in small children requires special consideration. We report our 5-year experience with regards to safety, efficacy and advantages with optical balloon ports over conventional ports in retroperitoneal laparoscopic surgery.
Methods
Forty-two patients who underwent laparoscopic nephrectomy, heminephrectomy, pyeloplasty with a retroperitoneal approach in between June 2015 and July 2020 were selected for the study. These patients were divided in to two groups of 21 each. Patients in Group 1 underwent conventional port placement while patients in Group 2 were subjected to optical balloon port insertion. The time taken for access
,
gas leak, the need of wound extension for specimen removal, safety and complication rates were compared.
Results
Age of the patients ranged from 5 months to 17 years. No complications or conversion to an open approach were recorded. In Group 1, the mean time for access was 9 (5–19) min. Gas leak was recorded in 13 patients, wound extension for specimen removal required in 6 patients and muscle closure all patients. In Group 2 the mean time taken for access was 2.5 (1–7) min (
p
 < 0.05), there was no gas leakage recorded. Among 12 patients wound extension was necessary for specimen removal. Muscle closure was performed only among 12 patients in Group 2.
Conclusion
Optical technique provides quick and safe access to the retroperitoneum with no air leak, however, it requires modification of the technique in small children.