Initial experience with magnet-assisted single trocar appendectomy in children.
BACKGROUND
Single-incision laparoscopic surgery (SILS) is increasingly being used to treat acute appendicitis. Existing SILS techniques suffer from inefficient triangulation and poor ergonomics. In an effort to improve on existing SILS techniques, we developed the magnet-assisted single trocar (MAST) appendectomy.


METHODS
We retrospectively analyzed all MAST appendectomies performed between March 2010 and February 2011. Outcomes included demographics, diagnosis, operative time, hospital stay, and complications.


RESULTS
Twenty-three MAST appendectomies were performed in 10 boys and 13 girls. The mean age at operation was 12.22 years (range, 5-19 years), and the mean weight was 46.5 kg (range, 25-82 kg). At presentation the mean white blood cell count was 15,000 with 74% polymorphonuclear neutrophils. The mean operative time was 61 minutes (range, 20-105 minutes), and length of stay was 3.6 days (range, 1-7 days). In total, 4 operations (17%) required one additional 5-mm trocar to complete the operation, and none was converted to an open operation. There were no intraoperative complications, nor were there any wound infections.


CONCLUSIONS
MAST appendectomy is safe and effective in children. Magnetic instruments provide excellent triangulation and improve ergonomics. This technique uses a single 12-mm trocar and can be performed without the aid of a surgical assistant.
Department of Pediatric Surgery, Fundacion Hospitalaria Private Children's Hospital, Buenos Aires, Argentina.
Benjamin E
BE
Padilla
Guillermo
G
Dominguez
Carolina
C
Millan
Horacio
H
Bignon
Enrique
E
Buela
Gaston
G
Bellia
Maria Eugenia
ME
Elias
Mariano
M
Albertal
Marcelo
M
Martinez-Ferro
D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000295:instrumentation* / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D004867:Equipment Design; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D059346:Magnets; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult