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.
Based on our early experience and a review of the literature, we believe TLL is a feasible and technically reproducible approach that avoids the inherent morbidity of a major thoracotomy incision. Bleeding should not be the main argument to decide in favor of a thoracotomy. LigaSure's reliability would depend on vascular diameter and on patient age. VIs can be prevented in older children by using the sealing device and a proximal Hem-o-Lok clip.
A hybrid technique, combining magnets and a curved grasper, simplifies transumbilical surgery. It seems feasible and safe for TUC and potentially reproducible.
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