MICROINVASIVE LAPAROSCOPIC CHOLECYSTECTOMY IN PEDIATRIC-PATIENTS

Although cholelithiasis is uncommon in children, its laparoscopic trea tment has progressively become more popular among pediatric surgeons. This is due in part to the fact that compared with the open technique, laparoscopic treatment is less invasive as well as more cost-effectiv e, A review of the literature indicates that it has been customary to use at least one 10-mm port to permit application of the 10-mm endosco pic clip applier for ligation of the cystic duct and artery. We report our experience with two patients in whom a laparoscopic cholecystecto my was performed by use of a 5-mm endoscopic clip applier and a 3-mm l aparoscope, The application of a 5-mm clip applier obviated the need f or a 10-mm port. It also saved an additional step by eliminating the e xchange from the laparoscope to the 10-mm endoscopic clip applier thro ugh the 10-mm port, Furthermore, the use of a 3-mm telescope through t he smallest port (<5 mm) would achieve a better cosmetic outcome.