Our Summary

This research study looked at the learning curve of surgeons performing a specific type of surgery called single-incision laparoscopic surgery (SILS) for appendicitis in children. This type of surgery uses one small incision, rather than multiple ones, making it less invasive for the patient. The researchers wanted to see how quickly surgeons could become proficient at this technique and whether it was safe for patients during the early stages of the surgeons’ learning process.

For the study, they looked back at data from 974 pediatric patients who had their appendix removed at a single hospital between 2005 and 2018. Out of these, 438 were done using the SILS technique. They measured things like how long the surgery and anesthesia lasted and the rate of complications.

The results showed that as surgeons performed more SILS procedures, their surgery times got quicker. Specifically, it appeared that surgeons became proficient at this technique after about 51 cases. Importantly, the rate of complications did not increase during the early stages of the surgeons learning this technique, indicating that it was safe for patients.

In simple terms, the study suggests that with practice, surgeons can get faster at performing this specific type of surgery without putting patients at risk during their early learning stages.

FAQs

  1. What is single-incision laparoscopic surgery (SILS) for appendicitis in children?
  2. How many cases does it take for surgeons to become proficient in the SILS technique according to the research study?
  3. Did the rate of complications increase as surgeons were learning the SILS technique?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic appendectomy is that it is a minimally invasive procedure that typically allows for quicker recovery times and less scarring compared to traditional open surgery. Additionally, the study mentioned above shows that surgeons can become proficient at performing single-incision laparoscopic surgery for appendicitis after about 51 cases, so patients can feel confident in the skills of their surgeon even during the early learning stages.

Suitable For

Patients who are typically recommended for laparoscopic appendectomy include those with uncomplicated appendicitis, meaning that the appendix has not ruptured or formed an abscess. This minimally invasive surgery is generally preferred for patients who are otherwise healthy and have a lower risk of complications. Additionally, laparoscopic appendectomy may be recommended for patients who are looking for a quicker recovery time and less scarring compared to traditional open surgery.

Timeline

Before the laparoscopic appendectomy:

  1. Patient experiences symptoms of appendicitis such as abdominal pain, nausea, and fever.
  2. Patient seeks medical attention and is diagnosed with appendicitis through physical examination, blood tests, and imaging studies.
  3. Patient is scheduled for a laparoscopic appendectomy to remove the inflamed appendix.

After the laparoscopic appendectomy:

  1. Patient undergoes the laparoscopic appendectomy procedure, which involves making small incisions in the abdomen and inserting a camera and surgical instruments to remove the appendix.
  2. Surgery typically lasts around 30-60 minutes.
  3. Patient is monitored in the recovery room before being discharged from the hospital, usually within 24 hours.
  4. Patient may experience some pain and discomfort at the incision sites, which can be managed with pain medication.
  5. Patient is advised to rest and avoid strenuous activities for a few days to allow for proper healing.
  6. Patient follows up with their surgeon for post-operative care and to ensure that they are recovering well.
  7. Patient gradually resumes normal activities as they continue to recover from the surgery.

What to Ask Your Doctor

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

  1. How experienced are you in performing laparoscopic appendectomies, particularly using the single-incision technique?
  2. What are the potential benefits of undergoing a laparoscopic appendectomy compared to traditional open surgery?
  3. What are the potential risks or complications associated with a laparoscopic appendectomy?
  4. How long is the recovery time expected to be after a laparoscopic appendectomy?
  5. Will I have a noticeable scar after the surgery, and if so, how can it be minimized?
  6. Are there any specific restrictions or activities to avoid during the recovery period?
  7. What is your protocol for managing pain after the surgery?
  8. How likely is it that additional procedures or a conversion to open surgery may be necessary during the procedure?
  9. What is the success rate of a laparoscopic appendectomy in treating appendicitis?
  10. Are there any long-term effects or considerations to keep in mind after undergoing a laparoscopic appendectomy?

Reference

Authors: Esparaz JR, Jeziorczak PM, Mowrer AR, Chakraborty SR, Nierstedt RT, Zumpf KB, Munaco AJ, Robertson DJ, Pearl RH, Aprahamian CJ. Journal: J Laparoendosc Adv Surg Tech A. 2019 Oct;29(10):1306-1310. doi: 10.1089/lap.2019.0112. Epub 2019 Jun 19. PMID: 31219394