title: Umbilical one-puncture laparoscopic-assisted appendectomy in children.
abstract: To perform a laparoscopic appendectomy, three trocars are usually needed. In order to reduce abdominal wall trauma, we have adopted an umbilical one-puncture laparoscopic-assisted appendectomy (UOPLAA). We did a retrospective study of UOPLAA performed during last 2 years on 200 children aged from 5 to 18 years (median, 9 years). The patients were selected after clinical examination. No child with advanced generalized peritonitis or an abscess with a palpable mass was a candidate for this technique. UOPLAA was successful in 184 patients (92%). In 16 cases (8%), an additional trocar was required to manage perforated or retrocecal appendicitis. The mean operative time was 15 min, and the mean hospital stay was 2 days. There were no intraoperative complications. There were 10 (5%) postoperative complications (three parietal and seven intraabdominal). Four patients (2%) needed reoperation under general anesthesia. The UOPLAA is our preference in cases of acute nonperforated appendicitis because it is simple and fast, with good cosmetic results; but in 8% of our cases, an intraoperative difficulty (retrocecal location, abnormal adhesive band, peritonitis, etc.) arose that required the introduction of additional devices to ensure the safety of the laparoscopic procedure.
authors.affiliation: Fondation Lenval for Children, 57, Avenue de la Californie, 06200 Nice, France.
authors.forename: J
authors.initials: J
authors.lastname: Valla
authors.forename: R M
authors.initials: RM
authors.lastname: Ordorica-Flores
authors.forename: H
authors.initials: H
authors.lastname: Steyaert
authors.forename: T
authors.initials: T
authors.lastname: Merrot
authors.forename: A
authors.initials: A
authors.lastname: Bartels
authors.forename: J
authors.initials: J
authors.lastname: Breaud
authors.forename: C
authors.initials: C
authors.lastname: Ginier
authors.forename: M
authors.initials: M
authors.lastname: Cheli
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011677:Punctures; D012189:Retrospective Studies; D016896:Treatment Outcome; D014472:Umbilicus