https://doi.org/10.4081/pmc.2023.306

Transumbilical laparoscopic-assisted appendectomy versus laparoscopic appendectomy in children: a single center experience

Vol. 45 No. 1 (2023)
Published: April 27 2023
laparoscopic appendectomy, laparoscopic learning curve, minimally invasive surgery, pediatric appendicitis, pediatric surgery
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Authors

Edoardo Bindi
edo.bindi88@hotmail.it
Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy; Università Politecnica of Marche, Ancona, Italy.
Fabiano Nino
Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy.
Francesco Pierangeli
https://orcid.org/0000-0002-5938-303X
Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy.
Michele Ilari
Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy.
Taisia Bollettini
https://orcid.org/0000-0002-6494-7282
Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy.
Elisa Chiarella
Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy.
Francesca Mariscoli
Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy.
Gianluca Gentilucci
Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy.
Alba Cruccetti
Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy.
Giovanni Cobellis
Pediatric Surgery Unit, Salesi Children’s Hospital, Ancona, Italy; Università Politecnica of Marche, Ancona, Italy.

Laparoscopic Appendectomy (LPSA) is the first choice for appendectomy in pediatric surgery. Trans-Umbilical Laparoscopic Assisted Appendicectomy (TULAA) is another used technique. We compared both these procedures used for the treatment of acute appendicitis. The study was conducted between January 2019 to December 2020. Patients were divided into two groups: LPSA and TULAA groups. The collected data were: operative time, number of conversions, time of canalization and hospital stay. A total of 181 patients were included: 73 were kept in the LPSA and 108 in the TULAA group. Mean operative time was 70.9 minutes (range 45-130 min) for LPS and 56.4 (30-145 min) for TULAA group (p <0.0001). Complications rate showed no statistically significant difference between both the two groups. However, conversions showed a statistically significant difference (p=0.04). Both techniques showed similar results. TULAA technique takes a significantly shorter operating time. The selection between LPSA and TULAA techniques depends on the experience of the surgeon’s work and the personal laparoscopic learning curve. In our experience LPSA was a useful technique to improve the laparoscopic skill of the pediatric surgery residents.

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Scopus
Google Scholar
Europe PMC
Cameron DB, Williams R, Geng Y, et al. Time to appendectomy for acute appendicitis: a systematic review. J Pediatr Surg 2018;53:396–405. DOI: https://doi.org/10.1016/j.jpedsurg.2017.11.042
Hansen GL, Kleif J, Jakobsen C, Paerregaard A. Changes in incidence and management of acute appendicitis in children-a population-based study in the period 2000-2015. Eur J Pediatr Surg 2021;31:347-352. DOI: https://doi.org/10.1055/s-0040-1714655
Bhangu A, Søreide K, Di Saverio S, et al. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet 2015;386:1278–87. DOI: https://doi.org/10.1016/S0140-6736(15)00275-5
Molinaro F, Angotti R, Bindi E. Low weight child: can it be considered a limit of robotic surgery? Experience of two centers. J Laparoendosc Adv Surg Tech A 2019;29:698-702. DOI: https://doi.org/10.1089/lap.2017.0681
Molinaro F, Krasniqi P, Scolletta S, et al. Considerations regarding pain management and anesthesiological aspects in pediatric patients undergoing minimally invasive surgery: robotic vs laparoscopic–thoracoscopic approach. J Robotic Surg 2020;14:423–430. DOI: https://doi.org/10.1007/s11701-019-01005-1
Maita S, Andersson B, Svensson JF, et al. Nonoperative treatment for nonperforated appendicitis in children: a systematic review and meta-analysis. Pediatr Surg Int 2020;36:261-269. DOI: https://doi.org/10.1007/s00383-019-04610-1
Pogorelic Z, Buljubasic M, Susnjar T, et al. Comparison of open and laparoscopic appendectomy in children: A 5-year single center experience. Indian Pediatr 2019;56:299-303. DOI: https://doi.org/10.1007/s13312-019-1518-2
Minneci PC, Hade EM, Lawrence AE, et al. Association of nonoperative management using antibiotic therapy vs laparoscopic appendectomy with treatment success and disability days in children with uncomplicated appendicitis. JAMA 2020;324:581-593. DOI: https://doi.org/10.1001/jama.2020.10888
Pogorelić Z, Kostovski B, Jerončić A, et al. A comparison of endoloop ligatures and nonabsorbable polymeric clips for the closure of the appendicular stump during laparoscopic appendectomy in children. J Laparoendosc Adv Surg Tech A 2017;27:645-650. DOI: https://doi.org/10.1089/lap.2016.0433
Rakić M, Jukić M, Pogorelić Z, et al. Analysis of endoloops and endostaples for closing the appendiceal stump during laparoscopic appendectomy. Surg Today 2014;44:1716-22. DOI: https://doi.org/10.1007/s00595-013-0818-8
Pogorelić Z, Beara V, Jukić M, et al. A new approach to laparoscopic appendectomy in children-clipless/sutureless Harmonic scalpel laparoscopic appendectomy. Langenbecks Arch Surg 2022;407:779-787. DOI: https://doi.org/10.1007/s00423-021-02389-1
Cobellis G, Torino G, Noviello C, et al. Versatility of one-trocar surgery in children. J Laparoendosc Adv Surg Tech A 2011;21:549-54. DOI: https://doi.org/10.1089/lap.2010.0063
Noviello C, Romano M, Martino A, et al. Transumbilical laparoscopic-assisted appendectomy in the treatment of acute uncomplicated appendicitis in children. Gastroenterol Res Pract 2015;2015:949162. DOI: https://doi.org/10.1155/2015/949162
Deng Y, Chang DC, Zhang Y, et al. Seasonal and day of the week variations of perforated appendicitis in US children. Pediatr Surg Int 2010;26:691–696. DOI: https://doi.org/10.1007/s00383-010-2628-z
Rentea RM, Peter SDS, Snyder CL. Pediatric appendicitis: state of the art review. Pediatr Surg Int 2017;33:269–283. DOI: https://doi.org/10.1007/s00383-016-3990-2
Smith J, Fox SM. Pediatric abdominal pain: an emergency medicine perspective. Emerg Med Clin North Am 2016;34:341–361. DOI: https://doi.org/10.1016/j.emc.2015.12.010
Visnjic S. Transumbilical laparoscopically assisted appendectomy in children: high-tech low-budget surgery. Surg Endosc 2008;22:1667–1671. DOI: https://doi.org/10.1007/s00464-007-9680-3
Karam PA, Mohan A, Buta MR, Seifarth FG. Comparison of transumbilical laparoscopically assisted appendectomy to conventional laparoscopic appendectomy in children. Surg Laparosc Endosc Percutan Tech 2016;26:508–512. DOI: https://doi.org/10.1097/SLE.0000000000000334
Martino A, Zamparelli M, Cobellis G, et al. One-trocar surgery: a less invasive videosurgical approach in childhood. J Pediatr Surg 2001;36:811-4. DOI: https://doi.org/10.1053/jpsu.2001.22968

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Transumbilical laparoscopic-assisted appendectomy versus laparoscopic appendectomy in children: a single center experience. (2023). La Pediatria Medica E Chirurgica, 45(1). https://doi.org/10.4081/pmc.2023.306
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