Our Summary

This research paper is about a study conducted at a children’s hospital on the use of a single-incision laparoscopic appendectomy (SILA), a surgery method that involves making only one small cut in the abdomen to remove the appendix. This method was compared to the more traditional three-port laparoscopic appendectomy (CLA), which involves making three incisions. The study looked at records from 2012 to 2017 and found that out of 1001 appendectomies performed, 95.9% started with the plan to use the SILA method. However, the study found that males, patients with a high body mass index, or patients with a burst appendix were more likely to need to switch to the CLA method. The study also found that the SILA method had similar rates of readmission and length of hospital stay to the CLA method, but had a significantly faster surgery time. The researchers concluded that the SILA method is safe and efficient for treating appendicitis in children, but parents of children who are male, obese, or have a burst appendix should be informed that the surgery may need to switch to the CLA method.

FAQs

  1. What is the difference between a single-incision laparoscopic appendectomy (SILA) and a three-port laparoscopic appendectomy (CLA)?
  2. What factors may cause a switch from the SILA method to the CLA method during surgery?
  3. Does the SILA method result in a shorter hospital stay or lower readmission rates compared to the CLA method?

Doctor’s Tip

A helpful tip a doctor might tell a patient about appendectomy is to follow post-operative care instructions carefully, including taking prescribed medications, avoiding strenuous activities, and keeping the incision site clean and dry to prevent infection. It is also important to follow up with your doctor for any concerns or complications after surgery.

Suitable For

Patients who are typically recommended for an appendectomy include:

  1. Patients with acute appendicitis: The most common reason for undergoing an appendectomy is acute appendicitis, which is inflammation of the appendix. Symptoms of acute appendicitis include abdominal pain, nausea, vomiting, and fever.

  2. Patients with a perforated appendix: In some cases, the appendix may rupture or perforate, leading to infection and abscess formation. In these cases, surgery is necessary to remove the appendix and clean out the infection.

  3. Patients with recurrent appendicitis: Some patients may have a history of recurrent episodes of appendicitis, leading to chronic abdominal pain and discomfort. In these cases, surgery may be recommended to prevent future episodes.

  4. Patients with atypical symptoms: In some cases, the symptoms of appendicitis may be atypical, making it difficult to diagnose. In these cases, surgery may be recommended to rule out appendicitis and prevent complications.

  5. Patients with a tumor or mass in the appendix: Rarely, a tumor or mass may develop in the appendix, leading to symptoms such as abdominal pain, weight loss, and changes in bowel habits. In these cases, surgery may be recommended to remove the tumor and prevent further complications.

Overall, appendectomy is a common and safe surgical procedure that is recommended for a variety of patients with appendicitis or related conditions. It is important for patients to consult with their healthcare provider to determine the best treatment plan for their individual situation.

Timeline

Before the appendectomy:

  • Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  • Patient visits a doctor or emergency room for evaluation and diagnosis.
  • Imaging tests such as ultrasound or CT scan may be done to confirm appendicitis.
  • Surgery is scheduled for appendectomy.

After the appendectomy:

  • Patient undergoes pre-operative preparation and anesthesia before the surgery.
  • Surgeon performs the appendectomy using either the SILA or CLA method.
  • Patient is monitored in the recovery room for a few hours after surgery.
  • Patient may experience some pain and discomfort in the abdominal area.
  • Patient is discharged from the hospital within a day or two after surgery.
  • Patient is given instructions for post-operative care, including pain management, wound care, and diet.
  • Patient may experience a gradual recovery over the next few weeks, with a return to normal activities in about 2-4 weeks.

What to Ask Your Doctor

  1. What are the potential risks and benefits of a single-incision laparoscopic appendectomy compared to a traditional three-port laparoscopic appendectomy?
  2. How does the surgeon decide which method to use for an appendectomy?
  3. Are there any specific factors (such as gender, body mass index, or severity of appendicitis) that may increase the likelihood of needing to switch from a single-incision laparoscopic appendectomy to a traditional three-port laparoscopic appendectomy?
  4. What is the expected recovery time and post-operative care for each type of appendectomy?
  5. Are there any long-term effects or complications associated with either method of appendectomy?
  6. What is the success rate of single-incision laparoscopic appendectomy in treating appendicitis?
  7. Are there any alternative treatment options for appendicitis that should be considered?
  8. How many appendectomy procedures has the surgeon performed using the single-incision laparoscopic method?
  9. What is the overall experience and outcomes of patients who have undergone a single-incision laparoscopic appendectomy at your facility?
  10. Are there any specific precautions or guidelines that should be followed after undergoing a single-incision laparoscopic appendectomy?

Reference

Authors: Gates NL, Rampp RD, Koontz CC, Holcombe JM, Bhattacharya SD. Journal: J Surg Res. 2019 Mar;235:223-226. doi: 10.1016/j.jss.2018.08.050. Epub 2018 Oct 31. PMID: 30691799