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

Paul M Jeziorczak¹, Casey J Goodyear², Olivia A Perham¹

¹Department of Pediatric Surgery, OSF Healthcare Children's Hospital of Illinois, Peoria, Illinois, USA.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A

|February 19, 2025

Summary

Pediatric single-incision laparoscopic appendectomy successfully eliminated postoperative opioid use. This approach minimizes opioid reliance in children undergoing appendectomy for both perforated and nonperforated appendicitis.

Keywords:

appendectomy epidemic laparoscopic opiate pediatric single-incision

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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.