Laparoscopic appendectomy in children: evaluation of different techniques

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery

Background:

• Laparoscopic appendectomy is a common surgical approach for acute appendicitis.
• Clinical evidence supports laparoscopic appendectomy as a viable alternative to open surgery.

Purpose of the Study:

• To compare the outcomes of three distinct laparoscopic appendectomy techniques in pediatric patients.
• To identify the most effective and safest laparoscopic appendectomy method for acute appendicitis in children.

Main Methods:

• A comparative study involving 150 pediatric patients (ages 7-14) with acute appendicitis.
• Patients were randomized to undergo extracorporeal, Endoloop, or EndoGIA laparoscopic appendectomy.
• Outcomes were assessed based on clinical and hematologic indicators, operating time, complications, and hospital stay duration.

Main Results:

• The EndoGIA technique demonstrated significantly shorter operating times and no reported complications.
• Patients undergoing EndoGIA appendectomy experienced the shortest hospital stays, though not statistically significant.
• Extracorporeal laparoscopic appendectomy was associated with a higher frequency of complications, making it the least preferred method.

Conclusions:

• Laparoscopic appendectomy using the EndoGIA technique is the most recommended procedure for pediatric acute appendicitis, despite higher material costs.
• The Endoloop technique serves as a safe and preferable second option, particularly when EndoGIA is not accessible.
• Extracorporeal laparoscopic appendectomy is the least recommended due to its high complication rate.