scholarly journals Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children

2016 ◽  
Vol 38 (3) ◽  
Author(s):  
Paul Anthony Karam ◽  
Amy Hiuser ◽  
David Magnuson ◽  
Federico Gian Filippo Seifarth
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Intraoperative Complications ◽  
Open Appendectomy ◽  
Surgical Site Infections ◽  
Hybrid Technique ◽  
Modified Technique ◽  
Effective Technique ◽  
Operative Complications ◽  
Laparoscopic Assisted

Transumbilical laparoscopic assisted appendectomy combines laparoscopic single port dissection with open appendectomy after exteriorization of the appendix through the port site. Compared to the conventional three-port approach, this technique provides an alternative with excellent cosmetic outcome. We developed a safe and effective technique to perform an intracorporeal single port appendectomy, using the same laparoscope employed in the extracorporeal procedure. Retrospective review of 71 consecutively performed intracorporeal single port appendectomies and 30 conventional three-port appendectomies in children 6 to 17 years of age. A straight 10-mm Storz telescope with inbuilt 6 mm working channel is used to dissect the appendix, combined with one port-less 2.3 mm percutaneous grasper. Polymer WECK<sup>®</sup> hem-o-lock<sup>®</sup> clips are applied to seal the base of the appendix and the appendiceal vessels. No intraoperative complications were reported with the hybrid intracorporeal single port appendectomy or three-port appendectomy. There were two post-operative complications in the group treated with the single port hybrid technique: one intra-abdominal abscess and one surgical site infection. Groups did not differ in age, weight, and types of appendicitis. Operative times were shorter for the hybrid technique (70 <em>vs</em> 79 minutes) but did not differ significantly (P=0.19). This modified technique to a previously described single port extracorporeal appendectomy is easy to master and implement. It provides exposure similar to a three-port laparoscopic appendectomy, while maintaining virtually scarless results and potentially reduces the risk for surgical site infections compared to the extracorporeal technique.

scholarly journals Transumblical Single Incision Two-Port Laparoscopic Assisted Appendectomy: Early Experience in Paediatric Patients

2009 ◽  
Vol 22 (2) ◽  
pp. 289-294
Author(s):  
MA Nowshad ◽  
A Mostaque ◽  
SMA Shahid ◽  
HK Emrul
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Single Incision ◽  
Open Appendectomy ◽  
Operation Time ◽  
Randomized Controlled ◽  
Safe Technique ◽  
Port System ◽  
Laparoscopic Assisted ◽  
Additional Port

Laparoscopic appendectomy considered as superior alternative to open appendectomy. Usual laparoscopic appendectomy is performed with the three port system. In this study, we performed a unique single transumblical incision two-port laparoscopic assisted appendectomy with the aim to reduce postoperative port site complication as well as improving cosmesis and patients satisfaction. From January 2010, 32 patients were admitted with clinically diagnosed acute appendicitis and were randomly assigned to single transumblical incision two-port laparoscopic assisted appendectomy. Transumblical single incision two-port laparoscopic assisted appendectomy was attempted in all patients (9 males and 23 females) with an average age of 9.2 years. Transumblical single incision two-port laparoscopic assisted appendectomy was successfully completed in 31 patients. In one patient, another additional port required due to severe adhesion of the appendix. Mean operation time was 25.2 minutes (range, 17-38), and mean postoperative hospital stay was 1.Sdays (range 1-2). Postoperative complications (local pericaecal abscess) occurred in one case that was treated conservatively. Transumblical single incision two-port laparoscopic assisted appendectomy appears to be a feasible and safe technique for the treatment of acute appendicitis in the paediatric setting. It allows nearly scar less abdominal surgery. The true benefit of the technique should be assessed by randomized controlled trials.TAJ 2009; 22(1): 289-294

COMPARISION OF SURGICAL SITE INFECTION BETWEEN OPEN APPENDECTOMY AND LAPAROSCOPIC APPENDECTOMY

2021 ◽  
pp. 25-25
Author(s):  
J. Sudhakar ◽  
Manoj Karthik Gera
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Site Infection ◽  
Operative Complications ◽  
Bowel Movements ◽  
Perforated Appendix ◽  
Health Care Associated Infection

Appendectomy is most common surgical procedure in emergency surgery. Inamed appendix can be removed laparoscopically (laparoscopic appendectomy) or openly (open appendectomy). Surgical site infection is representative of health care associated infection in which it may effect on patients' morbidity and mortality. The aim of the study is to compare laparoscopic appendectomy and open appendectomy in terms of surgical site infection. The frequency of 60 patients who underwent appendectomy open appendectomy-40;laparoscopic appendectomy-20 between September 2019- march2020 which were retrospectively reviewed for demographic and pathological characteristic, recovery of bowel movements, length of hospital stay and post-operative complications. The frequency of purulent/gangrenous or perforated appendix were Laparoscopic appendectomy-10% and in open appendectomy 20%. The time of rst atus after surgery were 2.9 days and in open appendectomy were 2.97 days in laparoscopic appendectomy. Length of hospital stay were relatively short in laparoscopic appendectomy group and in open appendectomy group The frequency of overall surgical site infection were not that difference between the two groups laparoscopic appendectomy -15% open appendectomy group were22%But that of supercial surgical site infection was signicantly lower in laparoscopic appendectomy group5% open appendectomy group 15%.

A Nationwide Cohort Study of Outcome after Pediatric Appendicitis

2020 ◽  
Author(s):  
Erik Omling ◽  
Martin Salö ◽  
Saurabh Saluja ◽  
Sanna Bergbrant ◽  
Louise Olsson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Surgical Site Infections ◽  
Complicated Appendicitis ◽  
Increased Risk ◽  
Short And Long Term ◽  
Trends Over Time

Abstract Introduction Children with appendicitis often present with complicated disease. The aim of this study was to describe the clinical management of pediatric appendicitis, and to report how disease severity and operative modality are associated with short- and long-term risks of adverse outcome. Materials and Methods A nationwide retrospective cohort study of all Swedish children (<18 years) diagnosed with appendicitis, 2001 to 2014 (n = 38,939). Primary and secondary outcomes were length of stay, surgical site infections, readmissions, 30-day mortality, and long-term risk of surgery for small bowel obstruction (SBO). Implications of complicated disease and operative modality were assessed with adjustment for age, gender, and trends over time. Results Complicated appendicitis was associated with longer hospital stay (4 vs. 2 days, p < 0.001), increased risk of surgical site infection (5.9 vs. 2.3%, adjusted odds ratio [aOR]: 2.64 [95% confidence interval, CI: 2.18–3.18], p < 0.001), readmission (5.5 vs. 1.2, aOR: 4.74 [95% CI: 4.08–5.53], p < 0.001), as well as long-term risk of surgery for SBO (0.7 vs. 0.2%, adjusted hazard ratio [aHR]: 3.89 [95% CI: 2.61–5.78], p < 0.001). Intended laparoscopic approach was associated with reduced risk of surgical site infections (2.3 vs. 3.1%, aOR: 0.74 [95% CI: 0.62–0.89], p = 0.001), but no overall reduction in risk for SBO; however, successful laparoscopic appendectomy was associated with less SBO during follow-up compared with open appendectomy (aHR: 0.27 [95% CI: 0.11–0.63], p = 0.002). Conclusion Children treated for complicated appendicitis are at risk of substantial short- and long-term morbidities. Fewer surgical site infections were seen after intended laparoscopic appendectomy, compared with open appendectomy, also when converted procedures were accounted for.

scholarly journals Laparoscopic-assisted Appendectomy in Children with Uncomplicated Appendicitis

2021 ◽  
Vol 18 (1) ◽  
pp. 34-38
Author(s):  
Saeed Al Hindi ◽  
Husain Al Aradi ◽  
Mohamed Mubarak ◽  
Noor AlHashimi
Keyword(s):  
Acute Appendicitis ◽  
Operative Time ◽  
Pediatric Population ◽  
Intraoperative Complications ◽  
Open Appendectomy ◽  
Safe Alternative ◽  
Surgical Emergencies ◽  
Uncomplicated Appendicitis ◽  
Laparoscopic Assisted ◽  
First Time

Background: Acute appendicitis is one of the common surgical emergencies in the pediatric population. In 1990, laparoscopic-assisted  appendectomy was used in children for the first time. In this study, we present our initial experience with laparoscopic-assisted appendectomy in children, using two trocar sites, and assess it for safety and outcome. Methods: 76 cases with acute appendicitis underwent laparoscopic-assisted appendectomy at Salmaniya Medical Complex (SMC), Kingdom of Bahrain, between January 2012 and December 2015. These cases were reviewed prospectively. Results: 76 patients between 5 and 12 years underwent laparoscopic-assisted appendectomy at SMC. Operative time ranged from 25 to 45 min  (mean 33.93 min). Postoperative hospitalization ranged from 2 to 5 days (mean 2.88 days). One patient developed wound infection which  subsequently subsided with conservative treatment. One case was converted to open appendectomy, but without any intraoperative complications. All patients were followed up for 2 weeks, 1 month, and 3 months postoperatively. Conclusion: Laparoscopic-assisted appendectomy in children is a safe alternative to the open technique. The operative time in this technique and the length of hospitalization are both less and shorter than the open counterpart. No major intra-operative or postoperative complications were documented. Recovery was excellent. Keywords: Appendicitis, Laparoscopic-assisted appendectomy, Open appendectomy

scholarly journals Basic principles of laparoscopic appendectomy

2012 ◽  
Vol 65 (9-10) ◽  
pp. 383-387 ◽  
Author(s):  
Samir Delibegovic
Keyword(s):  
Laparoscopic Appendectomy ◽  
Simple Procedure ◽  
Open Appendectomy ◽  
Review Article ◽  
Basic Principles ◽  
Operative Complications ◽  
Cosmetic Effect ◽  
South Eastern Europe ◽  
Laparoscopic Techniques ◽  
Effect Technique

Introduction. Laparoscopic appendectomy is one of the simplest laparoscopic procedures, which is gradually becoming the method of choice in treatment of acute appendicitis due to its advantages over open appendectomy. In South-Eastern Europe the use of laparoscopic appendectomy is still very limited although it is a very simple procedure, suitable for training laparoscopic techniques. Technique of Laparoscopic Appendectomy. This review article describes the position of the patient and surgical team during laparoscopic appendectomy, position of troacars and working instruments which result in expressive cosmetic effect, technique of laparoscopic appendectomy, different ways of securing the base of appendix. Complications of Laparoscopic Appendectomy. This review article describes management of complicated appendicitis, and intra- and post-operative complications. Conclusion. Laparoscopic appendectomy has many advantages over open appendectomy. The risk of wound infection is lower, postoperative pain is weaker and the hospital stay is shorter.

scholarly journals Comparison of Outcome of Appendectomy: Laparoscopic versus Open Surgery in Combined Military Hospital, Savar

2021 ◽  
Vol 16 (2) ◽  
pp. 51-54
Author(s):  
Mohammad Faruq Iqbal ◽  
Arif Imtiyaz Chowdhury ◽  
Sharkar Rushdi Aziz
Keyword(s):  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Total Leukocyte Count ◽  
Military Hospital ◽  
Early Return ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Operative Complications ◽  
Duration Of Operation ◽  
Post Operative Complications

Introduction: Open appendectomy and laparoscopic appendectomy are two modalities in the treatment of appendicitis. Superiority of one over another is not clear. Objectives: To compare per-operative and post operative outcomes between open and laparoscopic appendectomy. Material and Methods: Prospective comparative study was conducted on patients with acute appendicitis who underwent open appendectomy (OA) (n=43) or laparoscopic appendectomy (LA) (n=59) from October 2018 to October 2019 in Combined Military Hospital (CMH), Savar. The two groups were compared in respect to patients' characteristics, duration of operation, operative findings, post operative pain, return of peristalsis, resume of oral feeding, post operative complications, return to activities and cosmesis. Statistical analysis was performed using SPSS 25.0. Continuous and categorical variables were analyzed using independent sample t test and chi-square test respectively and p <0.05 was considered statistically significant. Results: There was no statistical difference regarding patient characteristics between the two groups except total leukocyte count (TLC) and neutrophil count, both were higher in OA group (p<0.001). LA group was associated with less post operative pain (p<0.001), early resume of oral feed (OA-34.74±8.34 minutes vs LA-24.51±6.13 minutes; p<0.01), early return to light work (OA-4.26±1.3 days vs LA-2.53±0.7 days; p<0.001), heavy work (OA-66.93+19.38 days vs LA-37.36+10.02 days; p<0.001) and better cosmesis (highly satisfied in LA group 96.6% vs 30.2% in OA group). No significant difference was seen in duration of operation (50±13.72 and 53.31±7.69 minutes in OA and LA groups respectively; p>0.05). There was no significant difference in post operative complications (p>0.05). Conclusion: Laparoscopic appendectomy was found clearly superior to open appendectomy in terms of less post operative pain, early resume of oral feed, early return to light and heavy works and better cosmetic result. Both procedures are comparable in terms of duration of operation and post operative complications. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 51-54

EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

2017 ◽  
pp. 103-106
Author(s):  
Minh Duc Pham
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
University Hospital ◽  
Early Results ◽  
Sils Port ◽  
The Mean ◽  
A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

2011 ◽  
pp. 114-118
Author(s):  
Nhu Hiep Pham ◽  
Huu Thien Ho ◽  
Anh Vu Pham ◽  
Van Nghia Tran
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
Central Hospital ◽  
Surgical Department ◽  
A New Technique ◽  
Rate Female

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

scholarly journals Laparoscopic appendectomy versus antibiotic treatment for acute appendicitis—a systematic review

2021 ◽  
Author(s):  
Franziska Köhler ◽  
Anne Hendricks ◽  
Carolin Kastner ◽  
Sophie Müller ◽  
Kevin Boerner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Laparoscopic Appendectomy ◽  
Data Extraction ◽  
Open Appendectomy ◽  
Cochrane Library ◽  
Pubmed Database ◽  
Uncomplicated Appendicitis ◽  
Absence From Work

Abstract Background Over the last years, laparoscopic appendectomy has progressively replaced open appendectomy and become the current gold standard treatment for suspected, uncomplicated appendicitis. At the same time, though, it is an ongoing discussion that antibiotic therapy can be an equivalent treatment for patients with uncomplicated appendicitis. The aim of this systematic review was to determine the safety and efficacy of antibiotic therapy and compare it to the laparoscopic appendectomy for acute, uncomplicated appendicitis. Methods The PubMed database, Embase database, and Cochrane library were scanned for studies comparing laparoscopic appendectomy with antibiotic treatment. Two independent reviewers performed the study selection and data extraction. The primary endpoint was defined as successful treatment of appendicitis. Secondary endpoints were pain intensity, duration of hospitalization, absence from work, and incidence of complications. Results No studies were found that exclusively compared laparoscopic appendectomy with antibiotic treatment for acute, uncomplicated appendicitis. Conclusions To date, there are no studies comparing antibiotic treatment to laparoscopic appendectomy for patients with acute uncomplicated appendicitis, thus emphasizing the lack of evidence and need for further investigation.

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