Single-incision laparoscopic appendectomy vs multiport laparoscopic appendectomy in children: a retrospective comparison

Abstract

Background: Minimally invasive surgery is commonly used to treat appendicitis. Single-incision laparoscopic surgery is an attractive modality to treat a commonly occurring problem with the advantage of minimal or possibly no scarring. We sought to compare our results of single-incision laparoscopic appendectomy (SILA) with those of patients undergoing traditional multiport laparoscopic appendectomy (MPLA).

Patients and methods: A retrospective review of all patients who underwent a minimally invasive appendectomy from September 2009 to February 2010 was performed. The patients were divided into 2 groups based on if they had a SILA or a traditional MPLA. Outcomes including demographics, diagnosis, operative time, length of stay, narcotic usage, and complications were evaluated.

Results: A total of 110 patients underwent appendectomy. There were 50 patients who underwent SILA and 46 patients who underwent MPLA. Fourteen patients with perforated appendicitis were excluded. Mean age (11.1 vs 11.7 years, P = .43), weight (43.3 vs 50.9 kg, P = .27), and length of stay (1.1 vs 1.2 days, P = .56) were comparable between both groups. Operative time for SILA was slightly longer (33.8 vs 26.8 minutes, P = .01). Overall intravenous narcotic use was lower in the SILA group (0.9 vs 1.4 doses, P = .01), but there was no difference in the patients who also received ketorolac (0.8 vs 1.0 doses, P = .6). Four patients in the SILA group developed superficial wound infections and 1 patient in the SILA group was admitted for postoperative abscess.

Conclusions: Single-incision laparoscopic appendectomy is safe and effective in the pediatric population. Further studies should be performed to determine the impact on operative time and postoperative narcotic requirements.