Laparo-Endoscopic Single-Site Surgery ("Belly-Button" Surgery)

Children's Hospital Los Angeles is on the leading edge of minimally invasive surgical techniques, especially for children. One of the most recently developed areas within minimally invasive surgery is the use of laparo-endoscopic single-site (LESS) surgery, and we are one of the few hospitals in the nation to use this technique for children.

With LESS surgery, the surgeon is able to use special instruments to perform complex surgeries through a single incision site. LESS surgery is ofen favored by both families and physicians, as children experience lower pain, reduced blood loss and a shorter recovery time in the hospital after their procedure.

To further minimize the scarring that might result from surgery, the single incision made is in an area that will naturally hide any scars, such as the belly button. This gives the LESS surgery approach a reputation as being a virtually "scarless" surgery.

Our hospital is the largest center providing LESS surgery for children in the southwestern United States. 

Before Surgery

After Surgery

Patient Age

LESS surgery is feasible in young children and even infants. Surgeons at our hospital successfully removed a cystic kidney from a 35-day old infant using this technique. The procedure required the surgeons to be able to enter through the baby's belly button and then remove it from the child's abdominal cavity. At the child's five-week checkup, he showed no scarring or other side effects from the procedure.

Synonyms Used for LESS Surgery

Physicians and surgeons use several terms to refer to the LESS surgery approach, including:

  • SILS (single incision laparoscopic surgery)
  • Single-port laparoscopic surgery
  • Belly-button surgery
  • Virtually scarless surgery

Incision Size

The incision is as small as 10mm. Usually the area in and around the belly button is the preferred entry spot. This minimally invasive technique helps our surgeons to operate with the expectation of nearly invisible post-surgery scarring. 

Minimally invasive surgeons have used single-incision surgery as an approach for a range of clinical procedures. The LESS approach is a new and rapidly expanding area of surgical procedures.

Surgery Equipment

In order for the surgeon's work to take place, the single incision and port must accommodate both an endoscope and a camera with a light and high-definition video feed. These are necessary for the surgeon to be able to see inside the patient's body effectively for surgery to be completed. 

Procedures

The LESS approach to surgery is especially useful for removal of organs that are diseased. The following procedures are performed by the corresponding division listed:

Division of Pediatric Surgery

  • Appendectomy 
    Removal of the appendix
  • Cholecystomy 
    Removal of the gallbladder
  • Splenectomy 
    Removal of the spleen

Division of Urology

  • Gonadectomy 
    Removal of a sex organ that resides within the abdomen or stomach
  • Nephrectomy 
    Removal of a kidney

Publications

  • Laparoendoscopic Single-site Nephrectomy in Pediatric Patients: Initial Clinical Series of Infants to Adolescents.
    Koh CJ, De Filippo RE, Chang AY, Hardy BE, Berger A, Eisenberg M, Patil M, Aron M, Gill IS, Desai MM.
    Urology. 2010 Dec;76(6):1457-61. Epub 2010 Oct 23.
    http://www.ncbi.nlm.nih.gov/pubmed/20970837
  • Single-incision laparoscopic cholecystectomy in a pediatric population: a preliminary report.
    Emami CN, Garrett D, Anselmo D, Nguyen NX.
    Am Surg. 2010 Oct;76(10):1047-9.
    http://www.ncbi.nlm.nih.gov/pubmed/21105606