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Robot-Assisted Laparoscopic Splenectomy In Children: A Case Report with Literature Review
Published on: March 27, 2026
Transumbilical laparoscopically assisted appendectomy in children: high-tech low-budget surgery
1Department of Pediatric Surgery, Children's Hospital Zagreb, Klaiceva 16, Zagreb, 10000, Croatia. stjepan.visnjic@zg.htnet.hr
Surgical Endoscopy
|December 13, 2007
Summary
Transumbilical laparoscopically assisted appendectomy (TULAA) is significantly more cost-effective than traditional laparoscopic appendectomy (LA) techniques, including stapler (LAS) and loop (LAL) methods, in children. TULAA offers comparable safety and efficacy with reduced material costs.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Techniques
Background:
- Comparison of two laparoscopic appendectomy (LA) techniques: stapler (LAS) versus loop (LAL).
- Evaluation against transumbilical laparoscopically assisted appendectomy (TULAA).
Purpose of the Study:
- To compare the cost-effectiveness and clinical outcomes of TULAA versus traditional LA techniques in pediatric appendectomy.
- To assess operative time, complications, analgesic requirements, and hospital stay.
Main Methods:
- Retrospective analysis of 72 children undergoing appendectomy (2003-2006).
- Procedures included 34 LAS, 9 LAL, and 29 TULAA.
- Outcomes measured: operative time, complications, analgesia, hospital stay, and procedure cost based on supplies.
Main Results:
- TULAA material costs were significantly lower (14 USD) compared to LAS (113.5 USD) and LAL (91 USD).
- No significant differences in wound infections, postoperative complications, or hospital stay between LA and TULAA groups.
- Operative time was shorter for TULAA (33 min) compared to LA (39 min).
Conclusions:
- TULAA is substantially more cost-effective than LAS and LAL due to lower supply costs.
- TULAA demonstrates comparable safety and efficacy to LA techniques in pediatric appendectomy.
- TULAA is a suitable and resource-efficient minimally invasive option for pediatric appendectomy.