Laparoscope-Assisted Appendectomy in Children: The Two-Trocar Technique

Abstract

The excellent visualization permitted considerable time gain. Infectious complications were also low. This method is suggested as an alternative procedure for appendectomy, especially in children, because of their favorable anatomy.

Port extériorisation appendectomy—our experience

“…Less than optimum conditions prompted us to look for alternative techniques which combined the best of open and laparoscopy, which was in our opinion the port exteriorisation technique. This technique, performed predominantly using two ports and occasionally three ports, gained popularity initially in paediatric practice [5][6][7] and later in adult surgeries as well.…”

“…This compares well with the timings both of open procedure as well as that of laparoscopic appendectomy performed using port exteriorisation technique by other centres. 1,2,5,6 It is pertinent to point out that the time consumed is less than that of standard three ports appendectomy. …”

“…This compares well with the literature on this technique where the rates of success have ranged from 73% to 100%. 1,2,5,6 It is important to see the two and three port techniques as continuum of laparoscopic techniques and not as rivals. It is always wise to add a port or covert to "in" technique, should one require, selectively, based on the situation.…”

“…1,2,5,6 Thorough wound toilet and delayed primary suturing, after few days of dressing, may further reduce the infection rate of surgical sites.…”

“…1,2,5,6 Postoperative Pain Pain following laparoscopy is multifactorial with visceral and parietal components. 12 In the initial 24 hours the visceral component predominates while the parietal component takes over later, 12 as was seen in our study.…”