• Kyoichi Deie, Hiroo Uchida, Hiroshi Kawashima, Yujiro Tanaka, Takayuki Masuko, and Shinya Takazawa.
• Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, 339-8551, Japan.
• Pediatr. Surg. Int. 2013 Nov 1; 29 (11): 1187-91.

PurposeSingle-incision laparoscopic appendectomy was recently introduced as a less-invasive surgical technique than existing methods, and is increasingly being performed worldwide. We have started to perform transumbilical laparoscopic-assisted appendectomy (TULAA) in children. In this study, we assessed its feasibility, efficacy, and cost-effectiveness compared with conventional multiport laparoscopic appendectomy (MLA).MethodsWe retrospectively reviewed all of the patients who underwent MLA or TULAA between August 2009 and December 2012. Patient characteristics, operative time, length of hospital stay, postoperative complications, cost-effectiveness, and cosmetic results were analyzed.ResultsA total of 88 patients underwent laparoscopic appendectomy, with MLA in 48 patients and TULAA in 40 patients. TULAA was successful in 36/40 patients. There were no significant differences in mean operative time or mean length of stay between the two groups of patients. There were no postoperative complications in the TULAA group. The cost of TULAA was much lower than that of MLA. TULAA also provided nearly scarless surgery.ConclusionTULAA, in which the appendix is exteriorized via a combination of open and laparoscopic techniques, is a safe and effective procedure for treating appendicitis in children. TULAA is a cost-effective treatment that provides excellent cosmetic results.

16 keywords...

hide…