title: Appendix extraction after laparoscopic appendectomy in children: An easy, safe, and inexpensive technique.
abstract: BACKGROUND
  Laparoscopic appendectomy is becoming an increasingly common operation among children. It is well known that the abdominal wall should not be exposed to the appendix's inflamed tissue during its removal. Several ways to protect the retrieval site have been described, with controversial results. Elevated costs, large surgical wounds and high contamination risks are typical reported issues.
  
  
  OBJECTIVE
  We describe a safe, cheap and easy technique to remove the appendix after a laparoscopic appendectomy in pediatric patients.
  
  
  METHODS
  We retrospectively collected and analyzed the files of all children operated on at our institution for laparoscopic appendectomy between September 2004 and April 2015. To remove the appendix, we used the cut end of a glove's finger.
  
  
  RESULTS
  We performed 291 laparoscopic appendectomies using this technique during an 11-year period. Patients' ages ranged from 2 to 16years old. The appendix could be extracted using this technique in all the cases. No intraoperative complications related to the technique were observed. Overall, only one patient (0.34%) presented wound complications.
  
  
  CONCLUSIONS
  Avoiding wide surgical incisions and abdominal wall contaminations is essential during laparoscopic appendectomies in children. Our easy, safe and cheap technique allows these important goals to be achieved.
authors.affiliation: Department of Pediatric Surgery, Ospedale Regionale Bellinzona e Valli, 6500 Bellinzona, Switzerland.
authors.forename: Mario
authors.initials: M
authors.lastname: Mendoza-Sagaon
authors.affiliation: Department of Pediatric Surgery, Ospedale Regionale Bellinzona e Valli, 6500 Bellinzona, Switzerland.
authors.forename: Flurim
authors.initials: F
authors.lastname: Hamitaga
authors.affiliation: Department of Pediatric Surgery, Ospedale Regionale Bellinzona e Valli, 6500 Bellinzona, Switzerland. Electronic address: yhurni@gmail.com.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Hurni
authors.affiliation: Department of Pediatric Surgery, Ospedale Regionale Bellinzona e Valli, 6500 Bellinzona, Switzerland.
authors.forename: Natalia
authors.initials: N
authors.lastname: Voumard
mesh_terms: D000293:Adolescent; D001062:Appendectomy / Q000295:instrumentation / Q000379:methods*; D001065:Appendix / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D017575:Gloves, Protective; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D012189:Retrospective Studies
keywords: Appendix extraction; Appendix retrieval; Laparoscopic appendectomy in children