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.
Fall M, Gueye D, Welle IB, et al. Laparoscopic appendectomy in children: preliminary study in paediatric hospital Albert Royer, Dakar. Gastroent Res Pract 2015;2015:878732. DOI: 10.1155/2015/878372.
Stevenson RJ. Chronic right-lower-quadrant abdominal pain: is there a role for elective appendectomy? J Pediatr Surg 1999;34(6):950–954. DOI: 10.1016/S0022-3468(99)90766-2.
Styrud J, Eriksson S, Nilsson I, et al. Appendectomy vs antibiotic treatment in acute appendicitis. A prospective multicenter randomized controlled trial. World J Surg 2006;30(6):1033–1037. DOI: 10.1007/s00268-005-0304-6.
Podevin G, Barussaud M, Leclair MD, et al. Appendicitis and appendicular peritonitis in children. EMC-Pediatrie 2005;2(3):211–219. DOI: 10.1016/j.emcped.2005.07.001.
Rai R, Chui CH, Sai Prasad TR, et al. Perforated appendicitis in children: bene tsof early laparoscopic surgery. Ann Acad Med Singap 2007;36(4):277–280.
Uday SK, Venkata Pavan Kumar CH, Bhargav PRK. A technique of single-incision laparoscopic appendectomy using conventional multiport laparoscopic instruments (SILACI): preliminary experience of 32 cases. Indian J Surg 2015;77(Suppl 3):S764–S768. DOI: 10.1007/s12262-013-0996-z.
Donmez T, Hut A, Avaroglu H, et al. Two-port laparoscopic appendectomy assisted with needle grasper comparison with comparison with conventional laparoscopic appendectomy. Ann Surg Treat Res 2016;91(2):59–65. DOI: 10.4174/astr.2016.91.2.59.
Gupta RK, Gupta A, Kothari P, et al. Transumbilical laparoscopic-assisted appendectomy: a safe and useful technique for interval appendectomy in paediatric population. J Minim Invasive Surg Sci 2014;3(3):et4365.
Semm K. Endoscopic appendectomy. Endoscopy 1983;15(2):59–64. DOI: 10.1055/s-2007-1021466.
Coletta LAD, Gil BZ, Zanatto RM. Minilapaparoscopic appendectomy. Arq Bras Cir Dig 2016;29(1):53–56. DOI: 10.1590/0102-6720201600010014.
Stylianos S, Nichols L, Ventura N, et al. The “all-in-one” appendectomy: quick, scarless, and less costly. J Pediatr Surg 2011;46(12):2336–2341. DOI: 10.1016/j.jpedsurg.2011.09.029.
Visnjic S. Transumbilicallaparoscopically assisted appendectomy in children: high-tech low-budget surgery. Surg Endosc 2008;22(7):1667–1671. DOI: 10.1007/s00464-007-9680-3.
Valla J, Ordorica-Flores RM, Steyaert H, et al. Umbilical one-puncture laparoscopic-assisted appendectomy in children. Surg Endosc 1999;13(1):83–85. DOI: 10.1007/s004649900906.
Petnehazy T, Saxena AK, Ainoedhofer H, et al. Single-port appendectomy in obese children: an optimal alternative? Acta Paediatrica (Oslo, Norway: 1992) 2010;99(9):1370–1373. DOI: 10.1111/j.1651-2227.2010.01791.x.
Bae SU, Jeong WK, Baek SK. Single-port laparoscopic interval appendectomy for perforated appendicitis with a periappendiceal abscess. Ann Coloproctol 2016;32(3):105–110. DOI: 10.3393/ac.2016.32.3.105.
Go DY, Boo YJ, Lee JS, et al. Transumbilical laparoscopic-assisted appendectomy is a useful option for Paediatric uncomplicated appendicitis: a comparison with conventional 3-port laparoscopic appendectomy. Ann Surg Treat Res 2016;91(2):80–84. DOI: 10.4174/astr.2016.91.2.80.
Deie K, Uchida H, Kawashima H, et al. Singleincisionlaparoscopicassisted appendectomy in children: exteriorization of the appendix is a key component of a simple and costeffective surgical technique. Pediatr Surg Int 2013;29(11):118791. DOI: 10.1007/s00383-013-3373-x.
Ohno Y, Morimura T, Hayashi S. Transumbilical laparoscopically assisted appendectomy in children: the results of a singleport, singlechannel procedure. Surg Endosc 2012;26(2):523–527. DOI: 10.1007/s00464-011-1912-x.
Kumar A, Sinha AN, Deepak D, et al. Single incision laparoscopic assisted appendectomy: experience of 82 cases. J Clinical Diag Res 2016;10(5):PC01–PC03. DOI: 10.7860/JCDR/2016/8146.7775.