**10.3 SIPES cholecystectomy**

Minimally invasive techniques have revolutionized surgical treatment. Few centers worldwide have advanced SIPES for pediatric age group. Many papers that were published in English literatures proved the safety and efficacy of SIPES cholecystectomy [44–48]. Up to our knowledge, there is no study regarding MOT of SIPES

**Figure 6.** *SIPES cholecystectomy 6 months post-op.*

cholecystectomy performed by trainees in patients with hematological disease. We conducted a retrospective study to determine the feasibility, safety, and expediency of SIPES cholecystectomy performed by trainees. 45 patients underwent SILS cholecystectomy. Age of the patients ranged from 7 to 16 years. Hematological disease were in >80% of cases. One extra port was needed in 2 patients in the beginning of the series. Eight procedures were done simultaneously, six splenectomy, one appendectomy, and one herniotomy, and were excluded from MOT. No conversion was needed. No wound infection. MOT is 85 ± 40 min. (**Figures 6** and **7**). It is comparable with conventional technique.


**151**

**11. Conclusion**

**Summary**

**Procedures**

SIPES hernia repair

suturing (PIRS)

percutaneous internal ring

PIRS is comparable with OH.

•

•

curve and best cosmetic result.

**Acknowledgements**

of innovative simulation strategies.

diseases.

*Single-Incision Pediatric Endosurgery (SIPES) DOI: http://dx.doi.org/10.5772/intechopen.85305*

**10.4 SIPES inguinal herniorrhaphy**

The approach to inguinal hernia in the pediatric population has historically been via an open technique. During recent years, laparoscopic surgery has emerged as an alternative in the treatment of pediatric inguinal herniorrhaphy. Different laparoscopic technique has been used, and SIPES is a recommended approach for management of inguinal herniorrhaphy [28]. SIPES inguinal herniorrhaphy gives opportunity to explore the contralateral side. We retrospectively review all SIPES inguinal hernia cases. MOT, intra- and postoperative complications, cosmetic results, and contralateral patencies of processus vaginalis (CPPV) were recorded. Patients were followed up for 4 months postoperatively. A total of 46 patients were operated, 39 (84.8%) were male, and 7 (15.2%) were female. Right side inguinal hernias were 18 (39.1%), left were 12 (26.1%), and bilateral sides were 16 (34.8%). 56.5% were less than 1 year, 19.6% were between 1 and 5 years, and 23.9% were 6–13 years old. Mean age is 2.7 years. For unilateral procedures MOT was 27 min. For bilateral procedures MOT was 40 minutes. Seven (23%) (CPPV) was found in

laparoscopic surgery. Stitch granuloma developed in one patient.

It needs good ancillary services for babies below 6 months of age.

**Age**

months– 12 years

2

SIPES has excellent cosmesis and almost invisible scar.

the safety, feasibility, and technical challenges of SIPES.

in Riyadh Saudi Arabia for their contribution.

We can do more than one procedure at the same time with SIPES technique. SIPES splenectomy is safe and feasible when performed by surgical trainees without adding any morbidity to the patients even those with hematological

**OT (min)**

20–45 **#**

46 **Conversion**

22 (extra port)

SIPES technique can be imparted satisfactorily to trainees. However, its successful incorporation into surgical training programs will depend on the development

Our aim is to standardize this approach and to reassure our colleagues regarding

We would like to acknowledge Dr Mohamed Al Onazi and his team from PSMC

SIPES appendectomy is feasible and safe in complicated appendicitis. SIPES cholecystectomy MOT is comparable with conventional technique. SIPES PIRS for inguinal herniorrhaphy is safe and efficient with good learning
