Laparoscopic Appendectomy in Children: Evaluation of Different Techniques

Shalaby, Rafik; Arnos, Abdo; Desoky, Ahmed; Samaha, A. Michael

doi:10.1097/00129689-200102000-00006

Cited by 22 publications

(11 citation statements)

References 18 publications

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“…The patients from this study were not included in the final analysis. Four studies compared LA using staplers and LA using loops [12,14,17,25]. Three of these studies had a three-armed design randomizing patients to laparoscopic appendectomy with loops, staplers, or a third procedure.…”

Section: Resultsmentioning

confidence: 99%

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Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling?

et al. 2006

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Background: This metaanalysis aimed to compare endoscopic linear stapling and loop ligatures used to secure the base of the appendix. Methods: Randomized controlled trials on appendix stump closure during laparoscopic appendectomy were systematically searched and critically appraised. The results in terms of complication rates, operating time, and hospital stay were pooled by standard metaanalytic techniques. Results: Data on 427 patients from four studies were included. The operative time was 9 min longer when loops were used (p = 0.04). Superficial wound infections (odds ratio [OR], 0.21; 95% confidence interval (CI), 0.06-0.71; p = 0.01) and postoperative ileus (OR, 0.36; 95% CI, 0.14-0.89; p = 0.03) were significantly less frequent when the appendix stump was secured with staples instead of loops. Of 10 intraoperative ruptures of the appendix, 7 occurred in loop-treated patients (p = 0.46). Hospital stay and frequency of postoperative intraabdominal abscess also were comparable in loop-treated and staple-treated patients. Conclusions: The clinical evidence on stump closure methods in laparoscopic appendectomy favors the routine use of endoscopic staplers.

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Section: Resultsmentioning

confidence: 99%

“…Three of these studies had a three-armed design randomizing patients to laparoscopic appendectomy with loops, staplers, or a third procedure. The third procedure was open appendectomy [17], extracorporeal stump ligation [25], or additional sinking of the appendix stump [12]. One trial was performed with children [25].…”

Section: Resultsmentioning

confidence: 99%

Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling?

et al. 2006

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“…Three methods of amputating the appendix have been described in children: stapling (using the EndoGIA, Ethicon Endosurgery), ligation (using an endoloop) or laparoscopicassisted extracorporeal appendicectomy (through the umbilical wound). The first two options were better in terms of incidence of complications compared to the latter in one paediatric trial 36 but not another. 28 The appendix is removed transumbilically, with or without the use of an endoscopic bag to protect the wound from direct soiling.…”

Section: Laparoscopic Appendicectomymentioning

confidence: 86%

Laparoscopic surgery in children

Davenport¹

2003

ann r coll surg engl

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“…It has been shown in a randomized study that the use of EndoGIA stapler (Ethicon EndoSurgery, Cincinnati, OH) can reduce the operative time by 15 minutes. 16 However, in our public hospitals, the operating room staff and anesthetists are paid a fixed monthly salary regardless of the fact that the emergency list is very seldom full in a 24-hour roster. Therefore, a slight reduction in operative time in the context of our financing structure has a relatively minor direct impact on fixed hospital expenses; in contrast, every 200 USD saved for not using one EndoGIA represents real savings.…”

Section: Discussionmentioning

confidence: 99%

An Optimal, Cost-effective Laparoscopic Appendectomy Technique for Our Surgical Residents

Ng¹,

Lee²,

Hui³

et al. 2004

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques

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Since early 1999, we have implemented a standardized technique for laparoscopic appendectomy, which is simple, safe and easily learned and mastered by our residents. Besides superior ergonomics, it offers cosmetic advantages. It is inexpensive as only reusable instruments are used. It incorporates useful modifications, such as the use of suprapubic ports, inferior approach with repositioning of the videoscope from the umbilical port to the left suprapubic port, laparoscopic gauze swabs and instrument-assisted knotting, as well as skeletonization of the appendix. We analyze the outcome of this technique between January 2000 and December 2002. The overall conversion rate of 713 laparoscopic appendectomies was 8.7%, which is comparable with the "best" rates in international literature. Operative times (mean, 59.0 minutes) and the complication rate (6.7%) compared favorably with previous reports on resident training. In summary, our residents feel comfortable with our standardized approach, while producing acceptable results with low cost.

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Laparoscopic Appendectomy in Children: Evaluation of Different Techniques

Cited by 22 publications

References 18 publications

Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling?

Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling?

Laparoscopic surgery in children

An Optimal, Cost-effective Laparoscopic Appendectomy Technique for Our Surgical Residents

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