WOFAPS 2025 8th World Congress of Pediatric Surgery

Paulina Vargova, Paolo Bragagnini Rodriguez, Carolina Corona Bellostas, Rafael Fernandez Atuan, Ainara Gonzalez Esgueda, Yurema Gonzalez Ruiz, Reyes Delgado Alvira, Marina Gonzalez Herrero, Javier Pison Chacon, Andrea Santino Tenorio, Alvaro Mayordomo Ruiz, Ricardo Escartin Villacampa

Hospital Universitario Miguel Servet

Aim of the study
To evaluate the effectiveness and outcomes of the transumbilical approach with glove-port in the treatment of intra-abdominal pathologies in pediatric surgery.

Patients and Methods
Pediatric patients operated on between 2017-2023 using a video-assisted technique with an artisanal glove-port.

Results
A transumbilical wound retractor was placed, with a single port made from a surgical glove and two trocars.
In 15 patients with Hirschsprung’s disease, the intestine was exteriorized for intraoperative biopsy. In 7 cases, additional trocars were used for intracavitary dissection and endoanal pull-through; in 8 cases, ileostomy and deferred pull-through were performed. There was one conversion to laparotomy and no cases of umbilical hernia.
In 12 neonates with intestinal atresia, laparoscopic inspection was performed using the glove-port, followed by exteriorization of the affected intestine, resection, and intestinal anastomosis. Three conversions to laparotomy were noted. A significant reduction in invasive ventilation time was observed (53 vs. 8 hours, p=0.039). Umbilical hernia developed in 16%, with no need for surgery.
In 6 neonates with a prenatal diagnosis of complicated ovarian cyst, exteriorization using the glove-port and cyst drainage was performed, followed by salpingo-oophorectomy with a sealing device.
Of 648 patients with acute appendicitis, 567 (87.5%) were treated exclusively with the glove-port, requiring an additional trocar in 77 cases. Conversion to open surgery was necessary in 21 patients, with no postoperative umbilical hernias.

Conclusions
The glove-port is a safe and efficient technique in pediatric surgery, enabling rapid exteriorization, avoiding repeated trocar insertion, minimizing contamination risks, and ensuring excellent aesthetic outcomes.