Our Summary

This research paper is about a study that compared two different surgical methods used to remove the appendix in children: single site laparoscopic appendectomy (SILA) and conventional 3-port appendectomy (CLA). The study looked at a number of things including how long the operation took, how long the child stayed in hospital, how quickly they could eat normally again, whether they had to go back to hospital, and how much each method cost. The study was done at Loma Linda University on 173 kids aged between 1 and 18, who had their appendix removed between 2018 and 2020.

The results showed that there was no big difference in the time it took to perform the operation, how quickly the kids could eat normally again, how long they stayed in hospital, or the cost of the operation between the two methods. However, a slightly higher number of kids who had the SILA operation had to go back to hospital because of abdominal abscesses (a collection of pus that forms inside the body).

The researchers concluded that more studies need to be done over a longer period to see if one method is better than the other.

FAQs

  1. What were the two surgical methods compared in the study for removing the appendix in children?
  2. What factors were considered in the comparison of the single site laparoscopic appendectomy (SILA) and the conventional 3-port appendectomy (CLA)?
  3. Were there any significant differences found between the two methods in terms of operation time, recovery, hospital stay, and cost?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic appendectomy is to follow post-operative instructions carefully to reduce the risk of complications such as abdominal abscesses. This may include taking prescribed medications, avoiding strenuous activities, and keeping the incision site clean and dry. It is also important to follow up with the surgeon for any concerns or symptoms that may arise after the procedure.

Suitable For

Typically, patients who are recommended for laparoscopic appendectomy are those with uncomplicated appendicitis, meaning that the appendix has not ruptured and there are no severe complications present. This includes patients who are experiencing symptoms such as abdominal pain, nausea, vomiting, and fever. Laparoscopic appendectomy is often recommended for children, adolescents, and adults who are in overall good health and do not have any underlying medical conditions that may complicate the surgery. It is important for patients to discuss their individual case with their healthcare provider to determine if laparoscopic appendectomy is the best treatment option for them.

Timeline

Before laparoscopic appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  2. Patient undergoes physical examination and diagnostic tests to confirm appendicitis.
  3. Patient is recommended for surgery to remove the inflamed appendix.

During laparoscopic appendectomy:

  1. Patient is prepped for surgery and given anesthesia.
  2. Surgeon makes small incisions in the abdomen and inserts a laparoscope to view the appendix.
  3. Appendix is removed using specialized surgical instruments.
  4. Incisions are closed with sutures or surgical glue.

After laparoscopic appendectomy:

  1. Patient wakes up from anesthesia and is monitored in the recovery room.
  2. Patient may experience some pain and discomfort at the incision sites.
  3. Patient is gradually encouraged to start walking and resume normal activities.
  4. Patient is discharged from the hospital within 24-48 hours.
  5. Patient is advised to avoid strenuous activities and follow up with the surgeon for post-operative care.
  6. Patient may experience some abdominal bloating and discomfort for a few days.
  7. Patient gradually resumes normal diet and activities as advised by the surgeon.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with both single site laparoscopic appendectomy (SILA) and conventional 3-port appendectomy (CLA)?
  2. How long will the operation take and what is the expected recovery time for each method?
  3. What is the likelihood of needing to go back to the hospital after the surgery, particularly in relation to abdominal abscesses?
  4. Are there any specific factors that may make one method more suitable for me than the other?
  5. What is the cost difference between SILA and CLA, and will my insurance cover the procedure?
  6. What is the experience of the surgical team with performing laparoscopic appendectomies, particularly with the method being recommended?
  7. Are there any alternative treatment options or surgical approaches that should be considered?
  8. How many laparoscopic appendectomies have been performed at the hospital, and what is the success rate with each method?
  9. What post-operative care will be required, and how can I ensure a smooth recovery process?
  10. Are there any long-term considerations or potential impacts on future health that I should be aware of?

Reference

Authors: Goodman LF, Lin AC, Sacks MA, McRae JJLH, Radulescu A, Khan FA. Journal: J Surg Res. 2021 Aug;264:321-326. doi: 10.1016/j.jss.2021.03.010. Epub 2021 Apr 10. PMID: 33848830