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  • Title: Umbilical center insertion method for initial trocar placement in pediatric laparoscopic surgery.
    Author: Nakaoka T, Uemura S, Yoshida T, Tanimoto T, Shiokawa C, Harumoto K.
    Journal: Osaka City Med J; 2010 Dec; 56(2):21-6. PubMed ID: 21466126.
    Abstract:
    BACKGROUND: For laparoscopic surgery in pediatric patients, the initial trocar insertion is usually made employing open laparotomy to avoid injury to the viscera. It is safe but somewhat time-consuming for establishing a pneumoperitoneum, and requires additional sutures for anchoring or preventing air leakage. We devised a new initial trocar insertion technique employing an umbilical center incision to shorten the surgical duration and improve the esthetic appearance. PATIENTS AND METHODS: Four hundred and thirty-one pediatric patients were indicated for this umbilical center insertion method (UCM) at 2 pediatric surgical departments. Patients suspected of having umbilical lesions (except for umbilical hernia) or extensive bowel adhesions were excluded. RESULTS: There was no complication associated with UCM. In almost all patients, a pneumoperitoneum was established within 1 minute. The wound was completely within the umbilical ring, and very satisfactory esthetically. DISCUSSION: We consider UCM to be a safe and easy procedure, and acceptable method of initial trocar insertion for pediatric laparoscopic surgery.
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