Our Summary

This research paper discusses a study that looked at the costs and outcomes of different surgical methods for treating appendicitis in children. Appendicitis surgeries make up about 30% of the total expenses in pediatric surgery. The study compared traditional three-incision laparoscopic surgery (TILS) with single-incision laparoscopy (SILS) and dual-incision laparoscopy (DILS).

Data was collected from a large children’s hospital over a three-year period. The study found that SILS and DILS were cheaper and took less time in the operating room than TILS. Importantly, the outcomes for the patients were equally good with all three methods.

The study suggests that if all appendicitis surgeries started with the single-incision method and only added more incisions if needed, a pediatric surgical center could save around $74,580 each year. This would be based on a center that performs an average of 314 laparoscopic appendectomies per year.

FAQs

  1. What surgical methods for treating appendicitis in children were compared in this study?
  2. What were the findings of the study in relation to the cost and duration of the different surgical methods?
  3. How much could a pediatric surgical center potentially save per year if all appendicitis surgeries started with the single-incision method?

Doctor’s Tip

A doctor might tell a patient that laparoscopic surgery for appendectomy is a safe and effective option, with single-incision laparoscopy (SILS) and dual-incision laparoscopy (DILS) being potentially more cost-effective and quicker procedures compared to traditional three-incision laparoscopic surgery (TILS). The outcomes for patients are equally good with all three methods, so the choice of surgical method may depend on individual circumstances and preferences.

Suitable For

Patients who are typically recommended for an appendectomy include those who present with symptoms of appendicitis, such as abdominal pain, nausea, vomiting, and fever. In some cases, imaging studies such as ultrasound or CT scans may be used to confirm the diagnosis.

Surgery is usually recommended for patients with acute appendicitis, as the condition can lead to serious complications if left untreated. In some cases, patients with a history of recurrent appendicitis or chronic appendicitis may also be recommended for surgery to prevent future episodes.

The study mentioned above specifically focused on pediatric patients, but the recommendations for appendectomy are generally similar for both children and adults. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine the best course of action for their individual situation.

Timeline

Before appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient undergoes physical examination and diagnostic tests such as blood tests, ultrasound, or CT scan to confirm appendicitis.
  3. Surgeon recommends appendectomy as the treatment for appendicitis.

After appendectomy:

  1. Patient undergoes pre-operative preparation including fasting and medication administration.
  2. Patient undergoes laparoscopic appendectomy surgery, which may involve traditional three-incision laparoscopy (TILS), single-incision laparoscopy (SILS), or dual-incision laparoscopy (DILS).
  3. Patient is monitored in the recovery room post-surgery for any complications.
  4. Patient is discharged from the hospital within a few days and given instructions for post-operative care.
  5. Patient experiences recovery period at home, which may involve pain management, rest, and gradual return to normal activities.
  6. Patient follows up with the surgeon for post-operative check-ups to ensure proper healing and recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about appendectomy include:

  1. What are the different surgical methods available for treating appendicitis?
  2. What are the potential risks and benefits associated with each surgical method?
  3. How long is the recovery time for each surgical method?
  4. Will there be any scarring after the surgery?
  5. How will pain be managed after the surgery?
  6. What are the potential complications that could arise during or after the surgery?
  7. How experienced is the surgical team in performing the chosen method?
  8. What are the costs associated with each surgical method?
  9. What is the success rate of each surgical method in treating appendicitis?
  10. Are there any alternative treatment options available for appendicitis?

Reference

Authors: Bence CM, Wu R, Somers KK, Szabo A, Arca MJ, Calkins CM, Gourlay DM, Oldham KT, Sato TT, Siddiqui SM, Densmore JC. Journal: J Pediatr Surg. 2019 Dec;54(12):2539-2545. doi: 10.1016/j.jpedsurg.2019.08.034. Epub 2019 Aug 30. PMID: 31519359