Transumbilical single-incision laparoscopic-assisted removal of gastric trichobezoars in children: a technical refinement and feasibility study.

BACKGROUND

Gastric trichobezoars are rare in children and adolescents and are often associated with psychiatric disorders such as trichotillomania and trichophagia. While surgical removal remains the definitive treatment for large bezoars, optimal management must consider not only technical success but also cosmetic outcomes, psychosocial impact, and feasibility in low-resource settings. The aim of the study was to evaluate the safety, feasiblity, and cosmetic of a transumbilical single-incision laparoscopic-assisted technique for gastric trichobezoar removal in children.

METHODS

We conducted a retrospective review of pediatric patients who underwent transumbilical single-incision laparoscopic-assisted removal of gastric trichobezoars. Demographic, characteristics, psychiatric comorbidity, clinical presentation, imaging findings, operative details, and postoperative outcomes were analyzed.

RESULTS

Five pediatric patients (median age 12 years; range, 9-14 years) were included. Psychiatric comorbidity was present in four of five patients (80%). Complete bezoar removal was achieved in all cases without conversion to open surgery. The median operative time was 120 min (range, 90-150 min). One patient developed a superficial wound infection that resolved with conservative management. The median hospital stay was 3 days (range, 2-4 days). Umbilical scars were well concealed in all patients, with satisfactory early cosmetic outcomes.

CONCLUSION

The transumbilical laparoscopic-assisted approach was safe and effective, with concealed scarring and demonstrated feasibility using standard surgical instruments.