Transumbilical single-incision laparoscopic appendectomy in pediatric appendicitis: A single-surgeon experience

INTRODUCTION: Appendicitis is the most frequent emergency in children. In recent years, transumbilical single-incision laparoscopic appendectomy (TULA), a single-incision procedure exteriorizing the appendix from inside the umbilicus, has shown shorter operation duration and almost invisible scars. In this study, we present our single-surgeon experience on TULA in the treatment of appendicitis in children and guide young surgeons who have started learning laparoscopy.
METHODS: Between January 2017 and December 2022, 79 patients with acute appendicitis who underwent TULA were retrospectively analyzed. The operation was performed as an emergency appendectomy. Data including demographic, laboratory, preoperative, and postoperative data were recorded.
RESULTS: Of the patients, 55 were boys and 24 were girls. The mean age was 10.4±2 (range, 5–17) years. The main symptoms were abdominal pain in 89.8% (n=71), anorexia in 31.6% (n=25), nausea in 36.7% (n=29), vomiting in 52.1% (n=65), and fever 13.9% (n=10). In the laboratory examinations, leukocytosis was identified in 62 (78.4%) patients and C-reactive protein value was elevated in 10 (87.3%) patients. Significant ultrasonographic findings were observed in 58 (73.4%) patients. The diagnosis was made in 21 (26.5%) patients using computed tomography.
DISCUSSION AND CONCLUSION: TULA is a less invasive procedure which can be performed in children and adolescents by a young surgeon easily and safely. It has a short operation time and hospital stay, and the rate of conversion to open surgery is also very low. This technique is a good start to learn laparoscopic surgery.