Our Summary

The study investigated two different methods of performing laparoscopic appendectomies (removing the appendix through small incisions using a camera) in children. The first method used a polymeric clip to close off the base of the appendix, while the second method used a tool called a Harmonic scalpel to seal the base without using a clip or suture.

312 children took part in the study, with 197 using the clip method and 115 using the scalpel method. The researchers found that the scalpel method had no postoperative complications, while there were 10 complications in the clip group. The scalpel method also led to shorter surgeries and hospital stays.

The study concluded that using the Harmonic scalpel for appendectomies in children is safe and effective, with fewer complications and quicker recovery times compared to the clip method.

FAQs

  1. What were the two methods of performing laparoscopic appendectomies investigated in the study?
  2. How many children took part in the study and which method did they undergo?
  3. What were the findings of the study regarding the use of the Harmonic scalpel versus the clip method for appendectomies in children?

Doctor’s Tip

A doctor might advise a patient undergoing a laparoscopic appendectomy to inquire about the use of a Harmonic scalpel for sealing the base of the appendix, as it has been shown to have fewer complications and shorter recovery times compared to using a polymeric clip. It is always important to discuss all available options with your surgeon to ensure the best outcome for your surgery.

Suitable For

Patients who are typically recommended for laparoscopic appendectomy include those with acute appendicitis, which is inflammation of the appendix that often requires surgical removal. Laparoscopic appendectomy is also recommended for patients who prefer a minimally invasive approach to surgery, as it involves smaller incisions, less pain, and quicker recovery times compared to traditional open surgery. Additionally, laparoscopic appendectomy may be recommended for patients who are at a higher risk for complications from open surgery, such as obese patients or those with underlying medical conditions.

Timeline

Before the laparoscopic appendectomy:

  • Patient experiences symptoms of appendicitis, such as abdominal pain, nausea, and fever.
  • Patient undergoes diagnostic tests, such as physical examination, blood tests, and imaging studies (such as ultrasound or CT scan) to confirm appendicitis.
  • Surgeon recommends laparoscopic appendectomy as the preferred treatment option.

During the laparoscopic appendectomy:

  • Patient is placed under general anesthesia.
  • Surgeon makes small incisions in the abdomen and inserts a camera and surgical instruments.
  • Surgeon identifies the appendix and removes it through the small incisions.
  • Surgeon closes off the base of the appendix using either a polymeric clip or a Harmonic scalpel.
  • Procedure typically lasts around 30-60 minutes.

After the laparoscopic appendectomy:

  • Patient is monitored in the recovery room before being transferred to a hospital room.
  • Patient may experience some pain and discomfort at the incision sites.
  • Patient is encouraged to walk around and resume a normal diet as tolerated.
  • Patient is typically discharged from the hospital within 1-2 days.
  • Patient may need to take pain medication and antibiotics as prescribed by the surgeon.
  • Patient is advised to avoid strenuous activities for a few weeks and follow up with the surgeon for a postoperative appointment.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a laparoscopic appendectomy?
  2. How does the use of a polymeric clip compare to a Harmonic scalpel in terms of closing off the base of the appendix?
  3. What are the advantages of using a Harmonic scalpel over a polymeric clip for a laparoscopic appendectomy in children?
  4. How long does the procedure typically take with each method?
  5. What is the expected recovery time for a patient undergoing a laparoscopic appendectomy with a Harmonic scalpel?
  6. Will there be any restrictions on activities or diet following the surgery?
  7. What follow-up care is necessary after a laparoscopic appendectomy with a Harmonic scalpel?
  8. Are there any long-term implications or considerations to be aware of after the surgery?
  9. How experienced is the surgeon in performing laparoscopic appendectomies with a Harmonic scalpel?
  10. Are there any alternative treatment options to consider for appendicitis?

Reference

Authors: Pogorelić Z, Beara V, Jukić M, Rashwan H, Šušnjar T. Journal: Langenbecks Arch Surg. 2022 Mar;407(2):779-787. doi: 10.1007/s00423-021-02389-1. Epub 2021 Nov 29. PMID: 34841456