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Related Experiment Video

Updated: Feb 17, 2026

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
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Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver

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Transumbilical extracorporeal laparoscopic-assisted appendectomy.

Lindsey Perea1, William H Peranteau1, Pablo Laje1

  • 1Division of General, Thoracic and Fetal Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Journal of Pediatric Surgery
|December 11, 2017
PubMed
Summary

Transumbilical extracorporeal laparoscopic-assisted appendectomy is a safe and cost-effective alternative for nonperforated appendicitis. This minimally invasive technique significantly reduces operative time and hospital stay compared to standard laparoscopic approaches.

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Oncology
  • Gastrointestinal Surgery

Background:

  • Appendicitis remains a common surgical emergency.
  • Current laparoscopic techniques aim for safety, cosmesis, and cost-effectiveness.
  • Optimizing these factors is crucial given rising healthcare costs.

Purpose of the Study:

  • To evaluate the safety and cost-effectiveness of the transumbilical extracorporeal laparoscopic-assisted appendectomy.
  • To compare this technique against the standard laparoscopic 3-port (L3P) method for nonperforated appendicitis.

Main Methods:

  • Retrospective review of 494 nonperforated appendicitis cases (Oct 2014-Oct 2016).
  • Cases divided into transumbilical (TU) and L3P groups.
  • Data collected on operative time, hospital stay, and costs.
Keywords:
AppendicitisLaparoscopic appendectomySingle-site appendectomy

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Main Results:

  • Transumbilical technique (n=161) had a mean operative time of 21 minutes vs. 37 minutes for L3P (n=333).
  • Mean hospital stay was 1.6 days for TU vs. 2.4 days for L3P.
  • TU cases were 30% less costly than L3P cases, with no difference in safety or complications.

Conclusions:

  • Transumbilical extracorporeal appendectomy is as safe as the L3P technique.
  • It offers a shorter hospital stay and is significantly more cost-effective.
  • This technique provides the benefits of minimally invasive surgery while improving economic outcomes.