A surgeon-friendly technique to perform single-incision laparoscopic appendectomy intracorporeally in children with conventional laparoscopic instruments.
BACKGROUND
Single-incision laparoscopic appendectomy (SILA) has been successfully performed in children. The intracorporeal approach, using reticulating instruments and 5- to 10-mm ports, has been described in recent reports. In this article, we describe our technique of performing SILA in children, using conventional 3- and 5-mm ports and instruments only.


METHODS
We conducted a retrospective review of all consecutive children who underwent SILA over a 3-month period by a standardized technique of using one 3-mm and two 5-mm ports. The procedure was completed intracorporeally by conventional instruments, and the specimen was retrieved without wound contamination by a simple method.


RESULTS
Eleven consecutive children (8-14 years), with a mean body weight of 38.5 kg, underwent successful SILA by our technique during the review period. Mean operating time was 83 minutes. There was no conversion to conventional laparoscopic or open appendectomy. Mean postoperative analgesic requirement was 2.4 doses of oral acetaminophen, and no narcotic analgesic was required. All the patients recovered smoothly without complications.


CONCLUSIONS
SILA can be safely performed in children when using standard laparoscopic instruments without additional costs in equipment. Using 3- and 5-mm ports seems more appealing to children, with their smaller umbilicus, than adults.
Tam
Yuk H
YH
Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China. pyhtam@hotmail.com
Lee
Kim Hung
KH
Sihoe
Jennifer D Y
JD
Chan
Kin W
KW
Cheung
Sing T
ST
Pang
Kristine K Y
KK
D000293:Adolescent; D001062:Appendectomy / Q000295:instrumentation / Q000379:methods*; D002648:Child; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies