Laparoscopic Appendectomy with Appendix Mass in Children

Abstract

Laparotomy for complicated appendicitis with a mass has been the traditional approach in the presence of acute lower abdominal pain, generalized peritonitis, and fever. Generous right iliac fossa incisions are routinely done to deal with these cases, as the appendectomy can be difficult due to visceral adhesion, omental wrapping, and early abscess formation within the mass. Laparoscopic appendectomy can result in decreased pain due to smaller wounds, as well as providing superior cosmesis.In a two-year study, 11 patients with appendicular masses were treated by laparoscopy. The procedure took an average of 120 6 20 min. All patients were ambulatory within 2 days. Hospital stay postsurgery was an average of 6 days. There was a single minor umbilical wound infection.Laparoscopic appendectomy can be recommended even in the presence of a preoperatively diagnosed appendicular mass and/or abscess. It does take longer than an open procedure, while cosmesis is superior and postoperative pain is less.

Risk Factors for the Development of Abdominal Abscess Following Operation for Perforated Appendicitis in Children

“…The use of laparoscopic appendectomy for cases of perforated appendicitis has been hotly debated, with some investigators citing higher rates of complications while others have found no increase in complications. [12][13][14][15][16][17][18] Our results did not support an association between method of operation and the development of a postoperative abscess.…”

New Primary Management for Appendiceal Masses in Children: Laparoscopic Drainage

“…16 However, evidence supporting LA in cases with AM is limited. Its use is rarely mentioned in the literature, and we could find only 2 other reports, 8,17 both of which concluded that LA was feasible and safe, obviating the need for a second admission (interval appendectomy), and that it is beneficial for preventing misdiagnosis. On the contrary, Lee and Yin 18 suggested that the presence of an AM is a contraindication for LA.…”

Laparoscopic Appendectomy in Children: Experience in a Single Centre in Chittagong, Bangladesh

“…The conversion rate in our series was kept to a minimum by adopting a new technique in difficult situations, that is, submucosal appendectomy [ 16 ]. Our policy with appendix mass was to proceed with primary intervention using laparoscopy and we did not face much difficulty during operation [ 22 ].…”