J Korean Surg Soc.  2012 Feb;82(2):110-115. 10.4174/jkss.2012.82.2.110.

Application of single incision laparoscopic surgery for appendectomy in children

• Kang DB
• Lee SH
• Lee SY
• Oh JT
• Park DE
• Lee C
• Choi DH
• Park WC
• Lee JK

• KMID: 2212209
• DOI: http://doi.org/10.4174/jkss.2012.82.2.110

Abstract

PURPOSE
Recently, single incision laparoscopic surgery (SILS) has been popular in use with its progress studied for more minimally invasive surgery and cosmetic improvement. We investigated the feasibility and efficacy of SILS for appendectomy (SILS-A) in children and compare it with conventional laparoscopic appendectomy (C-LA).
METHODS
We studied, retrospectively, adolescent patients who underwent C-LA or SILS-A. There were 25 patients in the C-LA group and 30 patients in the SILS-A group. The clinical outcomes were compared between the groups.
RESULTS
The SILS-A procedures were performed successfully in adolescent patients . There were no significant difference between the C-LA and SILS-A group with respect to demographic data and post-operative outcomes. There was one complication (4%) in the C-LA group and two complications (6.6%) in the SILS-A group, but there was no significant difference.
CONCLUSION
SILS-A was technically feasible and safe in children. Considering little postoperative scar and no difference in post-operative outcomes compared to C-LA, SILA could be applicable in adolescent patients. Larger studies and further technical implements will be necessary to assess the true benefit of this approach.

Keyword

Single incision; Laparoscopy; Child

MeSH Terms

Adolescent
Appendectomy
Child
Cicatrix
Cosmetics
Humans
Laparoscopy
Retrospective Studies
Cosmetics

Figure

• 

  Fig. 1 Extra-corporeal appendectomy in single incision laparoscopic surgery for appendectomy.

• 

  Fig. 2 Immediate post-operative scar after single incision laparoscopic surgery for appendectomy in 9-year-old female patient with gangrenous type appendicitis.

Reference

1. Towfigh S, Chen F, Mason R, Katkhouda N, Chan L, Berne T. Laparoscopic appendectomy significantly reduces length of stay for perforated appendicitis. Surg Endosc. 2006. 20:495–499.

2. Khan MN, Fayyad T, Cecil TD, Moran BJ. Laparoscopic versus open appendectomy: the risk of postoperative infectious complications. JSLS. 2007. 11:363–367.

3. Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a metaanalysis. J Am Coll Surg. 1998. 186:545–553.

4. White WM, Haber GP, Goel RK, Crouzet S, Stein RJ, Kaouk JH. Single-port urological surgery: single-center experience with the first 100 cases. Urology. 2009. 74:801–804.

5. Bucher P, Pugin F, Morel P. Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis. 2008. 23:1013–1016.

6. Kuon Lee S, You YK, Park JH, Kim HJ, Lee KK, Kim DG. Single-port transumbilical laparoscopic cholecystectomy: a preliminary study in 37 patients with gallbladder disease. J Laparoendosc Adv Surg Tech A. 2009. 19:495–499.

7. Oltmann SC, Rivas H, Varela E, Goova MT, Scott DJ. Single-incision laparoscopic surgery: case report of SILS adjustable gastric banding. Surg Obes Relat Dis. 2009. 5:362–364.

8. Hong TH, Kim HL, Lee YS, Kim JJ, Lee KH, You YK, et al. Transumbilical single-port laparoscopic appendectomy (TUSPLA): scarless intracorporeal appendectomy. J Laparoendosc Adv Surg Tech A. 2009. 19:75–78.

9. Kang KC, Lee SY, Kang DB, Kim SH, Oh JT, Choi DH, et al. Application of single incision laparoscopic surgery for appendectomies in patients with complicated appendicitis. J Korean Soc Coloproctol. 2010. 26:388–394.

10. Vidal O, Valentini M, Ginestà C, Martí J, Espert JJ, Benarroch G, et al. Laparoendoscopic single-site surgery appendectomy. Surg Endosc. 2010. 24:686–691.

11. Oltmann SC, Garcia NM, Ventura B, Mitchell I, Fischer AC. Single-incision laparoscopic surgery: feasibility for pediatric appendectomies. J Pediatr Surg. 2010. 45:1208–1212.

12. Semm K. Endoscopic appendectomy. Endoscopy. 1983. 15:59–64.

13. Horgan S, Cullen JP, Talamini MA, Mintz Y, Ferreres A, Jacobsen GR, et al. Natural orifice surgery: initial clinical experience. Surg Endosc. 2009. 23:1512–1518.

14. Saber AA, Elgamal MH, El-Ghazaly TH, Dewoolkar AV, Akl A. Simple technique for single incision transumbilical laparoscopic appendectomy. Int J Surg. 2010. 8:128–130.

15. Pelosi MA, Pelosi MA 3rd. Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med. 1992. 37:588–594.

16. Visnjic S. Transumbilical laparoscopically assisted appendectomy in children: high-tech low-budget surgery. Surg Endosc. 2008. 22:1667–1671.