Single-incision Laparoscopy-assisted Appendectomy in the Pediatric Age Group: Our Experience

JOURNAL TITLE: World Journal of Laparoscopic Surgery

Author
1. Hemanshi Shah
2. Neha Sisodiya Shenoy
3. Suraj Gandhi
ISSN
0974-5092
DOI
10.5005/jp-journals-10033-1406
Volume
13
Issue
2
Publishing Year
2020
Pages
3
Author Affiliations
    1. Department of Pediatric Surgery, Topiwala National Medical College & B.Y.L. Nair Charitable Hospital, Mumbai, Maharashtra, India
    1. Department of Paediatric Surgery, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India
    1. Department of Pediatric Surgery, Topiwala National Medical College & B.Y.L. Nair Charitable Hospital, Mumbai, Maharashtra, India
  • Article keywords

    Abstract

    Background: Various methods of laparoscopic appendectomy have been described in children. We present the data of 50 children who underwent interval appendectomy at our institution by transumbilical single-incision laparoscopy-assisted appendectomy (SILAA). Materials and methods: Fifty patients <12 years from June 2011 to June 2017 with inclusion criteria <12 years of age who were admitted with clinical features of acute appendicitis of >24–48 hours’ duration; had abdominal ultrasound (USG) with appendicular diameter of >10 mm and good clinical response to initial management by intravenous antibiotics within 24–48 hours of admission were retrospectively analyzed. They underwent SILAA after 6 weeks. Under general anesthesia, an infraumbilical incision was made and umbilical tube was identified. A 5 mm camera port was inserted by open Hassan's technique. After visualizing the appendix, another incision was made adjacent to the port site on the left and a 5 mm instrument was introduced through this. The appendix was freed, mobilized, and delivered through the incision. Appendectomy was completed extracorporeally. Results: The average age at presentation was 9.3 years. There were 18 females and 32 males. Two patients required conversion to open procedure in view of extensive adhesions and a short retrocecal appendix which was difficult to mobilize and exteriorize through umbilicus. The mean operating time was 30 minutes. There were no complications. Conclusion: Single-incision laparoscopy-assisted appendectomy combines the advantages of both laparoscopic and open appendectomy and offers reduced operative time and less complications and reduced surgical costs in pediatric age group.

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