Laparoscopic one port appendectomy: Evaluation in pediatric surgery
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In brief
In brief
Prospective comparative study of 80 pediatric patients evaluating single-incision laparoscopic appendectomy (SILA) versus conventional three-port laparoscopy. SILA demonstrated significantly shorter operative times, reduced postoperative pain and morphine requirements in the first 6 hours, faster recovery room discharge, and shorter hospital stays with no complications, supporting its safety and efficacy for routine and emergency pediatric appendicitis management.
Written by the GCMD Library team from the article.
Background
Appendectomy is a well-established surgical procedure in pediatric surgery used in the management of acute appendicitis. With the continuous advancement in the field of minimal invasive surgery, the recent focus is on single incision laparoscopic (SIL) surgery. SILA also goes further in order to decrease pain, improve recovery and enhance patient satisfaction. However, this approach is still not a well-established technique and not widely practiced, especially in pediatric surgery.
Methods
We prospectively recorded the data in our pediatric universitary hospital center since January, 01 2017 to July, 01 2017. Patients included in this study were randomized in two groups: SILA group (managed by one-port laparoscopy, n=40) and LA group (conventional laparoscopy using three trocars, n=40).
Results
The mean operative time for SILA was significantly lower. There were no postoperative complications in SILA group. If peritonitis was associated with appendicitis, the operative duration was not significantly different between each group. The duration in recovery room after surgery was significantly lower in SILA group. The morphine consumption was significantly lower for SILA group according to patient weight. SILA is less painful significantly than CLA for the first postoperative 6 h. After, even if SILA appears less painful, difference is not significant. The hospital length of stay was significantly higher in LA than SILA group
Conclusions
SILA procedure for appendectomy appears to be safe and efficient for appendicitis management in children. This technique could be applied in routine as in emergency tome.
Type of study
Prospective comparative study
Level of evidence
II