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Related Experiment Videos

Umbilical one-puncture laparoscopic-assisted appendectomy in children

J Valla1, R M Ordorica-Flores, H Steyaert

  • 1Fondation Lenval for Children, 57, Avenue de la Californie, 06200 Nice, France.

Surgical Endoscopy
|December 31, 1998
PubMed
Summary

Umbilical one-puncture laparoscopic-assisted appendectomy (UOPLAA) is a safe and effective technique for pediatric appendicitis. This minimally invasive approach offers cosmetic benefits and reduces hospital stays for most patients.

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Area of Science:

  • Minimally Invasive Surgery
  • Pediatric Surgery
  • Surgical Innovation

Background:

  • Traditional laparoscopic appendectomy typically requires three trocars, potentially increasing abdominal wall trauma.
  • Minimally invasive techniques aim to reduce surgical morbidity and improve patient outcomes.

Purpose of the Study:

  • To evaluate the safety, efficacy, and outcomes of umbilical one-puncture laparoscopic-assisted appendectomy (UOPLAA) in children.
  • To assess the feasibility of UOPLAA in reducing abdominal wall trauma compared to standard laparoscopic procedures.

Main Methods:

  • A retrospective study was conducted on 200 children (aged 5-18 years) who underwent UOPLAA over two years.
  • Patients were selected based on clinical examination, excluding those with advanced generalized peritonitis or abscess.

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  • Data collected included operative time, success rate, complications, and hospital stay.

    • Main Results:

    • UOPLAA was successful in 92% (184/200) of cases.
    • An additional trocar was needed in 8% (16/200) of cases, primarily for perforated or retrocecal appendicitis.
    • Mean operative time was 15 minutes, mean hospital stay was 2 days, with a 5% postoperative complication rate.

    Conclusions:

    • UOPLAA is a preferred technique for acute nonperforated appendicitis in children due to its simplicity, speed, and cosmetic advantages.
    • While effective, 8% of cases presented intraoperative challenges requiring additional trocars, highlighting the need for careful patient selection and surgical preparedness.