WOFAPS 2025 8th World Congress of Pediatric Surgery

Objectives : To compare the operative feasibility and complications encountered in paediatric laparoscopic surgeries while using ports or stab incision for instruments’ insertion

Methodology : This Retrospective study was conducted at the department of paediatric surgery Khyber Teaching Hospital Peshawar Pakistan after formal ethical approval from institutional review and ethical approval board. Three common Paediatric surgical procedures including pyloromyotomy, hernia repair and orchidopexy were considered and record from Feb 2022 to Feb 2025 was retrieved. Patients of either sex from 0 to 12 months were included in the study.Patients were divided into two groups.One included patients in which instrumentation was done via formal cannulation(ports placement) and other included those where instruments were inserted directly via simple small stab incision under laparoscopic vision. Operative time, incision site bleeding and incidence of leakage of gas were compared between the groups.Operative time was measured in minutes, and complications were recorded in percentages.Groups were compared for results and p value of less than 0.05 was considered significant

Results :

Among the 210 patients included in the study, 141 patients had undergone surgical procedures via formal ports insertion and 69 patients were operated via instruments access without port placement. For orchidopexy and pyloromyotomy the mean operative time was more in stab incision group as compared to cannulation group( p value of 0.004 and 0.003 respectively ) while for hernia repair the operative time difference was statiscally insignificant (p value =0.8). Incidence of gas leakage and site bleeding were more in stab group (p = 0.0005 & 0.0008 respectively) for all the three procedures.Rate of acces site infection was not different between the groups for all the three procedures( p= 0.78)

Conclusion: Standard method of Ports insertion for instrument access is a safe and feasible trend in Paediatric laparoscopic surgery with minimal complications and acceptable operative time.The apparently attractive stab incision for instrumentation does not bear any technical benefit.