Transumbilical Laparoscopic Assisted Single Port Appendectomy (Hybrid Appendectomy) in Children

ABSTRACT

PURPOSE: Laparoscopic appendectomy isused as a three port technique for appendectomy. In children, single port laparoscopic appendectomy is difficult because they have a small peritoneal cavity for manipulation of laparoscopic instruments. We performed transumbilical laparoscopic assisted single port appendectomy (hybrid appendectomy) in children. METHODS: From March 2010 to July 2012, we performed transumbilical laparoscopic assisted single port appendectomy in 53 children. We made a vertical incision to the umbilicus approximately 1.5 cm, and a wound retractor (Applied Medical Resources Co., Ltd., Rancho Santa Margarita) was placed in the umbilical incision, and appendix exteriorized the extraperitoneum through the wound retractor. Appendectomy was performed conventionally. We had no conversion cases for laparotomy. RESULTS: A total of 53 patients, 29 females and 24 males, with a mean age of 8.5+/-2.0 years were enrolled in this retrospective study. The mean operative time was 29.4+/-9.4 minutes. There was no occurrence of complication or mortality. BMI was 17.8+/-4.9 kg/m2. And mean hospital stay was 3.2+/-1.0 days. CONCLUSION: In children, transumbilical single port laparoscopic appendectomy is technically difficult because they have a small peritoneal cavity. However, transumbilical laparoscopic assisted single port appendectomy (hybrid appendectomy) appearsto be a safe and effective technique for use in children, which allows for achievement of nearly scarless surgery.