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Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...

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Transumbilical single-port appendectomy in children: a retrospective study.

Luísa Gomes Berto1, Carolina Lopez da Silva2, Marina Vieira Durante2

  • 1Graduate Program department, University of São Paulo, Bauru Campus, São Paulo, Brazil. luisagomesh@usp.br.

Pediatric Surgery International
|May 12, 2026
PubMed
Summary

Transumbilical single-incision laparoscopic appendectomy (TSILA) offers a safe alternative for appendicitis, leading to shorter hospital stays and less antibiotic use in early stages. Benefits in advanced cases were mainly reduced hospitalization time.

Keywords:
AppendectomyAppendicitisLaparoscopyMinimally invasive surgical proceduresPediatrics

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Area of Science:

  • Pediatric Surgery
  • Minimally Invasive Surgery
  • Surgical Outcomes

Background:

  • Acute appendicitis is a common surgical emergency in children.
  • Traditional surgical approaches include conventional laparoscopy and open surgery.
  • Transumbilical single-incision laparoscopic appendectomy (TSILA) is an emerging minimally invasive technique.

Purpose of the Study:

  • To compare the outcomes of TSILA with conventional laparoscopic and open appendectomy in pediatric patients.
  • To evaluate the safety and efficacy of TSILA across different grades of appendicitis.

Main Methods:

  • Retrospective analysis of 550 pediatric patients (0-18 years) undergoing appendectomy between 2020-2023.
  • Patients were stratified by surgical technique (TSILA, conventional laparoscopy, open surgery) and appendicitis grade (I-IV).
  • Statistical analysis using Pearson's Chi-squared and ANOVA tests.

Main Results:

  • TSILA was performed in 34.5% of cases, demonstrating significantly shorter hospital stays (2.98 days) compared to conventional laparoscopy (4.23 days) and open surgery (5.58 days).
  • Postoperative fever rates were lower with TSILA (7.9%) versus conventional laparoscopy (12.7%) and open surgery (27.5%).
  • Wound infection rates were similar for TSILA and conventional laparoscopy, both lower than open surgery; TSILA also showed the lowest postoperative antibiotic use.

Conclusions:

  • TSILA is a safe and effective surgical option for pediatric appendicitis, particularly in Grades I-III, associated with reduced hospital stays and antibiotic requirements.
  • In advanced appendicitis (Grade IV), TSILA provided shorter hospitalization, with comparable complication and antibiotic use rates to conventional methods.