Our Summary

This research paper studies the costs and outcomes of different surgical techniques for appendicitis in children. Appendicitis surgeries account for about 30% of the total cost of pediatric surgeries. The study compared three types of surgeries: traditional three-incision laparoscopy (TILS), single-incision laparoscopy (SILS), and dual-incision laparoscopy (DILS).

The study found that SILS and DILS were significantly less costly and took less time than TILS, while the outcomes were just as good. The researchers suggest that starting all appendicitis surgeries with SILS and then adding more incisions if needed could save a pediatric surgical center that performs an average of 314 appendicitis surgeries per year about $74,580 annually.

FAQs

  1. What surgical techniques for appendicitis in children were compared in the study?
  2. What were the cost and time implications of using SILS and DILS compared to TILS?
  3. How much could a pediatric surgical center potentially save annually by starting all appendicitis surgeries with SILS?

Doctor’s Tip

A doctor might tell a patient that a laparoscopic appendectomy is a minimally invasive procedure that involves smaller incisions, which can lead to less pain, faster recovery, and a shorter hospital stay compared to traditional open surgery. It is important to follow post-operative instructions carefully, including taking prescribed medications, avoiding strenuous activities, and attending follow-up appointments to ensure a smooth recovery.

Suitable For

Patients who are typically recommended for laparoscopic appendectomy include those with uncomplicated appendicitis, as laparoscopic surgery has been shown to have lower complication rates, shorter hospital stays, and quicker recovery times compared to open surgery. Additionally, patients who are younger, have a lower body mass index, and have no history of abdominal surgery may be good candidates for laparoscopic appendectomy. However, it is important to consult with a surgeon to determine the best surgical approach for each individual case.

Timeline

Before laparoscopic appendectomy:

  • Patient experiences symptoms of appendicitis such as abdominal pain, nausea, and fever
  • Patient undergoes physical examination and diagnostic tests such as blood tests and imaging studies to confirm the diagnosis of appendicitis
  • Patient is admitted to the hospital for surgery and undergoes pre-operative preparations such as fasting and receiving anesthesia

During laparoscopic appendectomy:

  • Surgeon makes small incisions in the abdomen and inserts a laparoscope to visualize the appendix
  • Surgeon removes the appendix using specialized instruments
  • Surgery typically takes about 30-60 minutes

After laparoscopic appendectomy:

  • Patient is monitored in the recovery room for a few hours
  • Patient may experience mild pain and discomfort at the incision sites
  • Patient is discharged from the hospital within 24 hours and instructed on post-operative care such as wound care and pain management
  • Patient can typically return to normal activities within 1-2 weeks

Overall, laparoscopic appendectomy is a minimally invasive procedure with shorter recovery time and less pain compared to traditional open appendectomy.

What to Ask Your Doctor

  1. What are the benefits of laparoscopic appendectomy compared to traditional open surgery?
  2. How experienced are you in performing laparoscopic appendectomies?
  3. What are the potential risks and complications associated with laparoscopic appendectomy?
  4. How long is the recovery time after a laparoscopic appendectomy?
  5. Are there any specific restrictions or precautions I should follow after the surgery?
  6. Will I need to stay overnight in the hospital after the surgery?
  7. How soon can I return to normal activities, such as work or exercise, after the surgery?
  8. Are there any long-term effects or complications I should be aware of after the surgery?
  9. How often do you perform laparoscopic appendectomies and what is your success rate?
  10. Are there any alternative treatment options for my 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