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Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review

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Laparoscopic appendicectomy in children: A trainee's perspective.

T R Sai Prasad¹, Chan Hon Chui, Anette Sundfor Jacobsen

¹Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore. trsai@rediffmail.com

Annals of the Academy of Medicine, Singapore

|November 15, 2006

Summary

Laparoscopic appendicectomy (LA) is a safe and effective training procedure for surgical residents. This study found LA to be suitable for all appendicitis stages in children, with no conversions to open surgery.

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Area of Science:

Pediatric Surgery
Minimally Invasive Surgery
Surgical Education

Background:

Operative laparoscopy necessitates standardized training protocols for surgical residents.
Clear guidelines for procedure selection, proficiency assessment, and accreditation in laparoscopic surgery are lacking.
Laparoscopic appendicectomy (LA) is evaluated as a potential training procedure from a trainee's perspective.

Purpose of the Study:

To assess the safety and efficacy of laparoscopic appendicectomy (LA) as a training procedure for surgical residents.
To evaluate LA's suitability for various stages of appendicitis and concurrent intra-abdominal conditions in pediatric patients.

Main Methods:

Retrospective analysis of consecutive LA cases performed by a surgical trainee.
Study period: September 2003 to February 2005.
Inclusion criteria: Pediatric patients (3-15 years) with suspected appendicitis.

Main Results:

70 pediatric patients underwent LA for suspected appendicitis.
Diagnoses included acute appendicitis (17.1%), suppurative appendicitis (35.7%), perforated appendicitis with peritonitis (41.4%), and normal appendix (5.7%).
No operative complications or conversions to open surgery were recorded; mean operative time was 55.6 minutes. Two post-operative complications (adhesive obstruction, wound infection) occurred.

Conclusions:

Laparoscopic appendicectomy (LA) is a safe and effective laparoscopic training procedure for pediatric surgical residents.
LA demonstrates efficacy across all stages of appendicitis and for concurrent lesions in children.
The findings support the use of LA for training and treatment in pediatric surgical settings.