Our Summary

This research paper discusses a new method of performing appendectomies, specifically in children. Traditional appendectomies involve making three small incisions in the abdomen, which is known as conventional laparoscopy (LA). However, the study looks at a method involving just one incision, known as single incision laparoscopic (SILA) surgery.

The researchers conducted a study at a pediatric hospital from January to July 2017. They divided the patients into two groups: one group received the one-incision surgery (SILA), the other received the three-incision surgery (LA).

They found that the one-incision surgery was faster, had fewer complications after surgery, had less recovery time, required less pain medication, and resulted in shorter hospital stays. The one-incision surgery also caused less pain in the first six hours after surgery compared to the three-incision surgery.

Overall, the study concludes that the one-incision surgery for appendectomies in children is safe and effective. They suggest this method could be used as a standard practice.

FAQs

  1. What is the difference between conventional laparoscopy (LA) and single incision laparoscopic (SILA) surgery in appendectomies?
  2. What were the findings of the study conducted on the two types of appendectomy surgeries?
  3. Is the one-incision surgery for appendectomies in children found to be safe and effective?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric appendectomy is that the single incision laparoscopic (SILA) surgery has been shown to have benefits such as faster recovery time, fewer complications, less pain, and shorter hospital stays compared to traditional laparoscopy (LA). It may be worth discussing this option with your healthcare provider to see if it is a suitable option for your child’s appendectomy procedure.

Suitable For

Typically, pediatric patients who require an appendectomy are recommended for this procedure. Appendectomies are commonly performed in children who have been diagnosed with appendicitis, which is inflammation of the appendix. Symptoms of appendicitis may include abdominal pain, fever, vomiting, and loss of appetite.

In cases where conservative treatment options, such as antibiotics, are not effective in treating appendicitis, surgery may be recommended. Children who have a ruptured appendix or are at risk of a rupture may also be recommended for an appendectomy.

The study mentioned above specifically looked at pediatric patients who required appendectomies and compared the outcomes of single-incision laparoscopic surgery versus conventional laparoscopic surgery. The results showed that the single-incision surgery had several advantages over the traditional three-incision surgery, making it a viable option for pediatric patients in need of an appendectomy.

Timeline

Before the pediatric appendectomy:

  • Patient experiences symptoms such as abdominal pain, nausea, vomiting, and fever
  • Patient undergoes physical examination, blood tests, and imaging studies to confirm appendicitis
  • Surgery is scheduled, and the patient undergoes pre-operative preparations such as fasting and anesthesia consultation

During the pediatric appendectomy:

  • Patient is brought into the operating room and placed under general anesthesia
  • Surgeon performs the appendectomy, either through conventional laparoscopy (LA) with three small incisions or single incision laparoscopic (SILA) surgery with one incision
  • Surgery typically lasts around 30-60 minutes

After the pediatric appendectomy:

  • Patient is monitored in the recovery room for a few hours
  • Patient may experience some pain and discomfort, which is managed with pain medication
  • Patient is encouraged to walk and resume normal activities gradually
  • Patient is discharged from the hospital typically within 24-48 hours after surgery
  • Follow-up appointments are scheduled to monitor the patient’s recovery and ensure there are no complications

Overall, the patient should experience relief from their symptoms and improved health after the pediatric appendectomy. The single incision laparoscopic surgery may provide a quicker recovery and less pain compared to traditional laparoscopy, as shown in the research study mentioned above.

What to Ask Your Doctor

Some questions a patient should ask their doctor about pediatric appendectomy using single incision laparoscopic surgery (SILA) include:

  1. What are the potential risks and complications associated with SILA surgery compared to traditional laparoscopic surgery?
  2. How does the recovery process differ between SILA surgery and traditional laparoscopic surgery?
  3. Will I experience less pain and require less pain medication with SILA surgery?
  4. How long will I need to stay in the hospital after SILA surgery?
  5. Are there any long-term effects or considerations to be aware of with SILA surgery?
  6. What is the success rate of SILA surgery for pediatric appendectomies?
  7. Are there any specific criteria or factors that make a patient a good candidate for SILA surgery?
  8. How experienced is the surgical team with performing SILA surgery in children?
  9. Will there be a noticeable scar from the single incision used in SILA surgery?
  10. Are there any lifestyle changes or restrictions I need to follow after undergoing SILA surgery?

Reference

Authors: Binet A, Braïk K, Lengelle F, Laffon M, Lardy H, Amar S. Journal: J Pediatr Surg. 2018 Nov;53(11):2322-2325. doi: 10.1016/j.jpedsurg.2017.12.018. Epub 2017 Dec 27. PMID: 29370892