Laparoscopic appendectomy in children

Abstract

Appendicitis is one of the most common pathologies in children. Laparoscopic appendectomy is now a frequently performed procedure and is probably the easiest laparoscopic therapeutic procedure to start with for training surgeons. Nevertheless its application remains controversial (Canty et al. 2000; Emil et al. 2003; Garbutt et al. 1999; Hermann and Otte 1997; Steyaert et al. 1999). The reasons for this are the good results obtained with standard open appendectomy and the fact that most appendectomies are performed during duty hours when not enough experience may be available. Conversely laparoscopy for right iliac fossa pain has an unquestionable diagnostic benefit, particularly in girls. Preoperative ultrasonography, however, is become more and more accurate in confirming or excluding appendicitis (Dilley et al. 2001). There are three different techniques of laparoscopic appendectomy: the "out" technique (Fig. 47.1), the "mixed in-out" technique (Fig. 47.2), and the "in" technique (Fig. 47.3). All three techniques will be described. © Springer-Verlag Berlin Heidelberg 2008.