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Minimally Invasive Surgery
Volume 2013, Article ID 165108, 5 pages
http://dx.doi.org/10.1155/2013/165108
Clinical Study

Laparoscopic-Assisted Single-Port Appendectomy in Children: It Is a Safe and Cost-Effective Alternative to Conventional Laparoscopic Techniques?

Department of Pediatric Surgery, University Children’s Hospital Basel, Spitalstrasse 33, 4056 Basel, Switzerland

Received 24 April 2013; Accepted 4 October 2013

Academic Editor: Peng Hui Wang

Copyright © 2013 Sergio B. Sesia and Frank-Martin Haecker. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. Laparoscopic-assisted single-port appendectomy (SPA), although combining the advantages of open and conventional laparoscopic surgery, is still not widely used in childhood. The aim of this study was to evaluate the safety and the cost effectiveness of SPA in children. Methods. After institutional review board approval, we retrospectively evaluated 262 children who underwent SPA. The appendix was dissected outside the abdominal cavity as in open surgery. For stump closure, we used two 3/0 vicryl RB-1 sutures. Results. We identified 146 boys (55.7%) and 116 girls (44.3%). Median age at operation was 11.4 years (range, 1.1–15.9). Closure of the appendiceal stump using two sutures (cost: USD 15) was successful in all patients. Neither a stapler (cost: USD 276) nor endoloops (cost: USD 89) were used. During a follow-up of up to 69 months (range, 30–69), six obese children (2.3%, body mass index >95th percentile) developed an intra-abdominal abscess after perforated appendicitis. No insufficiency of the appendiceal stump was observed by ultrasound. Five of them were treated successfully by antibiotics, one child required drainage. Conclusion. The SPA technique with conventional extracorporal closure of the appendiceal stump is safe and cost effective. In our unit, SPA is the standard procedure for appendectomy in children.