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

Ab s t r Ac t 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.