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Appendectomy using single-incision pediatric endosurgery for acute and perforated appendicitis
Oliver J Muensterer1, Cecilia Puga Nougues, Obinna O Adibe
1Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Alabama, University of Alabama at Birmingham, 1600 7th Avenue South, ACC 300, Birmingham, AL 35233, USA. oliver.muensterer@ccc.uab.edu
Single-incision pediatric endosurgical (SIPES) appendectomy is a viable alternative to conventional laparoscopy, particularly for acute appendicitis. This minimally invasive technique offers comparable outcomes with potential for reduced operative time in specific cases.
Area of Science:
- Pediatric surgery
- Minimally invasive surgery
- Surgical outcomes
Background:
- Single-incision pediatric endosurgical (SIPES) appendectomy is a technique utilized in select pediatric surgical centers.
- This study evaluates the adoption and outcomes of SIPES appendectomy across various appendicitis presentations.
Purpose of the Study:
- To report the experience with SIPES appendectomy for acute, perforated, and interval appendicitis.
- To compare SIPES appendectomy outcomes with conventional laparoscopic appendectomy from the previous year.
Main Methods:
- Prospective data collection for SIPES appendectomies, including operative time, complications, and length of stay.
- Stratification of cases into acute appendicitis, perforated appendicitis, and interval appendectomy.
- Comparison with historical controls of conventional three-trocar laparoscopic appendectomy.
Main Results:
- 75 SIPES appendectomies were performed; 20% required additional trocars.
- SIPES interval appendectomies showed higher conversion rates (33%).
- Wound infection rates were similar (4% in SIPES vs. 0.66% in controls).
- SIPES appendectomy for acute appendicitis demonstrated a significantly shorter operative time (37 min vs. 44.1 min, p=0.01).
Conclusions:
- SIPES appendectomy is a suitable alternative to conventional laparoscopy, especially for acute appendicitis.
- Perforated appendicitis and interval appendectomy present greater technical challenges with SIPES.
- Achieving scarless appendectomy is feasible with appropriate skill and consideration.
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