title: A surgeon-friendly technique to perform single-incision laparoscopic appendectomy intracorporeally in children with conventional laparoscopic instruments.
abstract: 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.
authors.affiliation: 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
authors.forename: Yuk H
authors.initials: YH
authors.lastname: Tam
authors.forename: Kim Hung
authors.initials: KH
authors.lastname: Lee
authors.forename: Jennifer D Y
authors.initials: JD
authors.lastname: Sihoe
authors.forename: Kin W
authors.initials: KW
authors.lastname: Chan
authors.forename: Sing T
authors.initials: ST
authors.lastname: Cheung
authors.forename: Kristine K Y
authors.initials: KK
authors.lastname: Pang
mesh_terms: D000293:Adolescent; D001062:Appendectomy / Q000295:instrumentation / Q000379:methods*; D002648:Child; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies