Single‐port appendectomy in obese children: an optimal alternative?

Petnehazy, Thomas; Saxena, Amulya K.; Ainoedhofer, H; Höellwarth, Michael E.; Schalamon, Johannes

doi:10.1111/j.1651-2227.2010.01791.x

Cited by 22 publications

(20 citation statements)

References 21 publications

(25 reference statements)

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“…Petnehazy et al [16] suggest that TULAA can be a simpler approach for appendectomy in obese children, and even if we did not stratify our population by weight in the present study, a single incision has proved to be a quick and effective approach for this kind of patients also in our hands. …”

Section: Discussionmentioning

confidence: 56%

Transumbilical Laparo-Assisted Appendectomy: A Safe Operation for the Whole Spectrum of Appendicitis in Children—A Single-Centre Experience

Codrich

Scarpa

Lembo

et al. 2013

Minimally Invasive Surgery

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The paper reports the results of a retrospective review of the medical charts of 203 patients admitted to a pediatric surgical unit with a diagnosis of acute appendicitis between January 2006 and December 2010 when a transumbilical laparoscopic-assisted appendectomy (TULAA) was introduced as a new surgical technique. Among 203 admitted patients, 7 (3.5%) had a localized appendiceal abscess and were treated with antibiotics. All of them responded to antibiotics and underwent TULAA interval appendectomy 8 weeks later. 196 patients (96.5%) underwent immediate surgery. In 12/181 (6.6%) urgent cases, conversion to laparotomy was necessary, in 3 patients because of bowel distension and in 9 for retrocecal position of appendix. In all 181 TULAA completed procedures, one trocar was used in 151 cases (89.4%), two trocars in 16 (9.4%), and three trocars in 2 (1.2%). The mean operative time for single port TULAA was 52′ Complications included 5 wound infections and 5 intra-abdominal abscesses, all managed conservatively. In conclusion, TULAA is a safe, minimally invasive approach with acute appendicitis, regardless of the perforation status, and can be recommended in the pediatric urgical settings.

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Section: Discussionmentioning

confidence: 56%

Transumbilical Laparo-Assisted Appendectomy: A Safe Operation for the Whole Spectrum of Appendicitis in Children—A Single-Centre Experience

Codrich

Scarpa

Lembo

et al. 2013

Minimally Invasive Surgery

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“…43 Problems inherent to SPILA include concerns over accidental tears when manipulating friable appendices, resulting in abdominal contamination, and port site contamination, given that the inflamed appendix makes direct contact with the wound (especially with 'hybrid' methods). 30 Navigating instruments in obese patients, in whom the umbilicus ceases to function as a useful landmark for distance to target organ, can further increase the difficulty of the procedure. 43 Complication rates obtained from SPILA case series appear similar to conventional laparoscopic and open appendicectomy procedures.…”

Section: Discussionmentioning

confidence: 99%

Technical approaches to single port/incision laparoscopic appendicectomy: a literature review

Rehman¹,

Ahmed

2011

annals

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INTRODUCTION Single port/incision laparoscopic surgery (SPILS) is a modern advancement toward stealth surgery. Despite the paucity of high-quality scientific studies assessing its effectiveness, this procedure is being used increasingly. This review aims to describe commonly used techniques for SPILS appendicectomies (SPILA), to summarise complication rates in the literature and to provide discussion on indications and implementation. METHODS All available databases including the Cochrane Central Register of Controlled Trials, MEDLINE ® and Embase ™ were searched in February 2011 and cross-referenced for available English literature describing SPILA in patients of any age. RESULTS Three broad technical approaches are described: procedures using laparoscopic instruments through a single skin incision in the abdominal wall, regardless of the number of fascial incisions, with or without the additional use of percutaneous sutures or wires to 'assist' the operation, and hybrid procedures, in which the appendix is exteriorised using a single incision laparoscopically assisted operation but subsequently divided using a conventional 'open' appendicectomy technique. Complication rates seem to be highest in SPILA procedures unassisted by sutures or wires. CONCLUSIONS Future research assessing the efficacy of single incision laparoscopic procedures should consider variation in technique as a possible factor affecting outcome.

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“…21 Although systematic studies on single-surgical access interventions especially in children are sparse, our findings underscore those of others, proofing that single-incision laparoscopic appendectomy is a safe technique even in young as well as obese children. 12,[21][22][23][24] In our study, all operations were laparoscopically completed without conversion or addition of extra ports. Mean operation time was similar for conventional laparoscopic and SIMPL appendectomy, which is in parallel to findings of others in adult and children.…”

Section: Postoperative Pain After Simpl Appendectomymentioning

confidence: 99%

Single-Incision Multiport Laparoscopy Does Not Cause More Pain Than Conventional Laparoscopy: A Prospective Evaluation in Children Undergoing Appendectomy

Mayer

Werner

Wachowiak

et al. 2011

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Single‐port appendectomy in obese children: an optimal alternative?

Abstract: Our results indicate that the advantages of single-port appendectomy in the evaluation of the peritoneal cavity, the minimal rate of intra-operative incidents with this technique and superior cosmetics validate this alternative approach of minimal access appendectomy in obese children.

Cited by 22 publications

References 21 publications

Transumbilical Laparo-Assisted Appendectomy: A Safe Operation for the Whole Spectrum of Appendicitis in Children—A Single-Centre Experience

Transumbilical Laparo-Assisted Appendectomy: A Safe Operation for the Whole Spectrum of Appendicitis in Children—A Single-Centre Experience

Technical approaches to single port/incision laparoscopic appendicectomy: a literature review

Single-Incision Multiport Laparoscopy Does Not Cause More Pain Than Conventional Laparoscopy: A Prospective Evaluation in Children Undergoing Appendectomy

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