One Less: Single-Incision Laparoscopic Appendectomy Facilitates Postoperative Opioid Avoidance.

Area of Science:

• Pediatric Surgery
• Pain Management
• Minimally Invasive Surgery

Background:

• The opioid epidemic necessitates strategies to reduce postoperative opioid use.
• Appendectomy is a common pediatric surgical procedure.
• Single-incision laparoscopic appendectomy offers a minimally invasive option.

Purpose of the Study:

• To review opioid utilization in pediatric patients after single-incision appendectomy.
• To compare outcomes for perforated versus nonperforated appendicitis.
• To assess the feasibility of opioid-free discharge after this procedure.

Main Methods:

• Retrospective review of 432 pediatric patients (<18 years) undergoing single-incision appendectomy.
• Data collected: length of stay, age, perforation status, and discharge opioid status.
• Study period: May 2018 - December 2021 at a single institution.

Main Results:

• Zero patients were discharged with opioids.
• Average length of stay was 2.1 days.
• Significant differences in length of stay and age between perforated and nonperforated cases (P < .001 and P < .01, respectively).

Conclusions:

• Single-incision laparoscopic appendectomy in children can be performed without postoperative opioid prescriptions.
• This approach is a viable strategy to mitigate opioid use in pediatric appendicitis management.
• The procedure is safe, well-tolerated, and achievable with standard laparoscopic equipment.