Less-invasive surgery for kids

Philadelphia - February 5, 2009 Melanie Perez, 13, of Bridesburg is a hard-working student. She spends most of her time studying and writing novels. "I want to be a writer when I grow up," she said.

She had perfect attendance at school until her mom Melissa said Melanie got sick while at her Holy Confirmation class. She was throwing up and in severe pain. "It was the worst pain I've never seen her in," she said, adding, "She went upstairs and started screaming."

They took her to St. Christopher's Hospital for Children. Doctors there found a large tumor on Melanie's right ovary. It wasn't cancerous, but it was twisting her ovary and had to come out.

To do that doctors could have made a large incision like one made for cesarean sections, or they could have done it laparoscopically, making three small incisions for different tools. Instead they opted to make just one small opening at her navel.

"A young woman might be concerned about the cosmetics of her abdomen so we thought it was worth a try to do it this way," said Dr. Matthew Moront, chief of trauma surgery at St. Christopher's.

He said single-port surgery is the latest advancement in kids' surgery. It's a growing trend for adults, but it's rarely been done in kids.

In Melanie's case, all through the same opening, surgeons used a camera and other tools to cut the tumor from the ovary, put it in a surgical bag, then drain it and remove it. "We were able to do it in probably a little less than an hour. So it was a little longer than it might have taken had I done it with the traditional [method,] but only 10 to 15 minutes longer," Dr. Moront said.

Two weeks later, and Melanie barely has a scar. Some patients also say the single port procedure leads to less pain than traditional laparoscopic procedures and recovery time is faster.

Melanie was back to writing and even Wii bowling in just a few weeks.

"I'm just thankful they found it and they were able to remove it. I think it's amazing they didn't have to cut her up too much and her healing time seems to be pretty good," her mother said.

Not all doctors are sold on this new technique but Dr. Moront stresses they only do the single-port surgery when it can be done as safely as traditional surgeries. The hope is it can be used more frequenly in the future to do common procedures such as appendectomies.

So far, ten single-port surgeries have been done at St. Christopher's. It is also being done at Alfred I. duPont Hospital for Children in Wilmington, Delaware.

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