Teaching single-incision laparoscopic appendectomy in pediatric patients

Area of Science:

• Minimally Invasive Surgery
• Surgical Education
• Pediatric Surgery

Background:

• Laparoscopic appendectomy is the standard for acute appendicitis.
• Single-incision laparoscopic surgery (SILS) has emerged as a feasible and safe option in pediatric patients.
• This study details the initial experience of teaching SILS for appendicitis within a community hospital surgical residency program.

Purpose of the Study:

• To evaluate the feasibility and safety of single-incision laparoscopic surgery (SILS) appendectomy in pediatric patients.
• To assess the learning curve and technical execution of SILS appendectomy by surgical residents.
• To explore the integration of SILS appendectomy into a surgical residency training program.

Main Methods:

• A prospective study of 40 consecutive pediatric patients with acute appendicitis undergoing SILS appendectomy.
• Inclusion criteria: patients over 4 years old with uncomplicated or complicated (perforated) appendicitis.
• Evaluation of the technical aspects of 20 SILS procedures performed by 3 PGY III residents.

Main Results:

• SILS appendectomy was successful in 19 out of 20 evaluated procedures (95% success rate).
• The mean operative time was 73 minutes (range: 47-112 minutes).
• A significant learning curve was observed among residents, with one conversion to conventional laparoscopy.

Conclusions:

• Single-incision laparoscopic surgery (SILS) shows promise for treating pediatric acute appendicitis.
• Successful implementation of SILS in surgical training necessitates the development of advanced simulation techniques.
• Further research into simulation-based training is crucial for widespread adoption of SILS appendectomy.