Rich Barrie S, Creasy John, Afaneh Cheguevara, Muensterer Oliver J
1 Division of Pediatric Surgery, Weill Cornell Medical College , New York, New York.
J Laparoendosc Adv Surg Tech A. 2014 Jan;24(1):43-9. doi: 10.1089/lap.2013.0294. Epub 2013 Oct 22.
As application and awareness of single-incision pediatric endosurgery (SIPES) are increasing, various techniques and indications have been independently described by select centers around the world. In order to facilitate a cooperative approach toward advancing and investigating the practice of SIPES, we conducted a survey among members of the International Pediatric Endosurgery Group (IPEG), asking them about their experience and attitudes toward single-incision endosurgery.
After institutional review board approval, an invitation to participate in an online survey was sent to all IPEG members. Questions focused on demographic information, practice patterns, indications, and equipment used regarding SIPES.
Of the 560 contacted active IPEG members, 115 completed the survey (recall 21%). The respondents represented pediatric surgeons from 32 countries on six continents. Of respondents, 97% had heard of, while 71% had performed, SIPES. Reasons for not having performed SIPES included disbelief in benefit (59%), lack of proficiency (34%), and inadequate resources (28%). The most commonly performed SIPES procedures were appendectomy (85%), cholecystectomy (66%), splenectomy (42%), pyloromyotomy (35%), and intestinal surgery (13%), as well as Nissen fundoplication and gynecologic adnexal pathology (7%). The equipment and techniques utilized showed large variation and included some self-devised, innovative, low-resource approaches. Complications with SIPES reported by the survey participants included technical difficulties, wound infection, and prolonged operating time.
SIPES is being performed worldwide for a large spectrum of common indications in pediatric surgery. The equipment and techniques used vary with geographic location and resources. Some encountered complications are common to those seen with conventional minimally invasive surgery, whereas others may be SIPES-specific. Different respondents reported diverging views on pain, operating time, and cost.
随着单切口小儿内镜手术（SIPES）的应用和认知度不断提高，世界各地的一些中心已分别描述了各种技术和适应证。为了促进以合作方式推进和研究SIPES的实践，我们对国际小儿内镜外科学组（IPEG）的成员进行了一项调查，询问他们对单切口内镜手术的经验和态度。
经机构审查委员会批准后，向所有IPEG成员发送了参与在线调查的邀请。问题集中在人口统计学信息、实践模式、适应证以及与SIPES相关的使用设备。
在联系的560名活跃IPEG成员中，115人完成了调查（回收率21%）。受访者代表来自六大洲32个国家的小儿外科医生。在受访者中，97%听说过SIPES，而71%进行过SIPES手术。未进行SIPES手术的原因包括不相信其益处（59%）、缺乏熟练度（34%）和资源不足（28%）。最常进行的SIPES手术是阑尾切除术（85%）、胆囊切除术（66%）、脾切除术（42%）、幽门肌切开术（35%）和肠道手术（13%），以及nissen胃底折叠术和妇科附件病变手术（7%）。所使用的设备和技术差异很大，包括一些自行设计的、创新的、资源有限的方法。调查参与者报告的SIPES并发症包括技术困难、伤口感染和手术时间延长。
SIPES在全球范围内用于小儿外科的多种常见适应证。所使用的设备和技术因地理位置和资源而异。一些遇到的并发症与传统微创手术常见的并发症相同，而其他一些可能是SIPES特有的。不同的受访者对疼痛、手术时间和成本的看法存在分歧。
