Stealth Surgery: Scarless Surgery

Our pediatric general surgery team is continually researching ways to improve surgical techniques to provide the best possible outcomes for our patients – physically, mentally and socially. Stealth surgery is one such improvement. The surgery is “stealth” because no scar, and therefore no evidence of the surgery, is left behind.

Reducing scarring as much as possible has lifelong positive social effects for our patients. Research has shown that children with scars often have lower levels of self-esteem, have impaired socialization skills, and are judged more negatively by other children.

We are proud to be one of the few teams in the country to perform stealth surgery on children. Some of our stealth surgery procedures are described below.

Nine-year-old Ryan was the first patient at Packard Children’s Hospital to have his spleen removed through a single incision in his belly button.

Gall Bladder, Spleen or Appendix Removal – Single Incision Laparoscopic Surgery (SILS)

Single incision laparoscopic surgery (SILS) is a scarless surgical technique used to remove diseased organs through just one hole in the child’s belly button. This includes:

• Gall bladder removal (cholecystectomy)
• Spleen removal (splenectomy)
• Appendix removal (appendectomy)

How the procedure is done. We insert a telescopic camera and light, and two operating instruments used to remove the organ through a small incision in the navel (belly button). Once the procedure is finished, the surgeon folds the belly button back into its normal shape, leaving no visible scar.

Pediatric general surgeon Sanjeev Dutta, MD, MA, published the first paper to describe SILS for pediatric cholecystectomy and the first to describe SILS splenectomy.

Sutureless Gastroschisis Closure

Gastroschisis is a defect in which the bowel, stomach and liver push through an opening in the wall of the abdomen. It is corrected shortly after birth.

How the procedure is done. Our surgeons use a sutureless approach and use the umbilical cord and a dressing to cover the hole in the abdomen. This allows the defect to close naturally over a few days, similar to how a cut heals.

Traditional surgery vs. sutureless closure. When compared to traditional gastroschisis surgery treatment, sutureless closure:

• Does not require a trip to the operating room, sutures or anesthesia
• Gives an excellent cosmetic result
• Shortens the length of time a newborn needs to stay on a ventilator
• Does not increase time spent in the Neonatal Intensive Care Unit (NICU)
• Does not increase time needed for the newborn to achieve full feeds

These findings were published in a 2009 paper in the Journal of Pediatric Surgery.