Should single-incision laparoscopic appendectomy be the new standard for pediatric appendicitis?

Preface: Should single-incision laparoscopic appendectomy the new standard for pediatric appendicitis?

“…SILA allows two instruments to work independently, whereas TULA involves single-plane traction, counter-traction, and dissection. 1 It is interesting to know that another port was far less frequently required in SILA with a glove-port wound protector than in TULA (1.1% vs. 13.5%, p < 0.01) for simple and complicated appendicitis (9.6% vs. 41.7%, p < 0.01). 1 In addition, fewer patients were placed drains in SILA than in TULA (21.9% vs. 75%, p < 0.01).…”

“…1 It is interesting to know that another port was far less frequently required in SILA with a glove-port wound protector than in TULA (1.1% vs. 13.5%, p < 0.01) for simple and complicated appendicitis (9.6% vs. 41.7%, p < 0.01). 1 In addition, fewer patients were placed drains in SILA than in TULA (21.9% vs. 75%, p < 0.01). In complicated appendicitis, no significant differences were observed between the two groups in the length of hospital stay, wound infection, intra-abdominal abscess (IAA), and adhesive intestinal obstruction.…”

“…For pediatric appendicitis, laparoscopic surgery with one umbilical incision has been frequently used over the past decade. 1 The transumbilical laparoscopic appendectomy (TULA) procedure is recommended for uncomplicated appendicitis in children due to its simplicity and improved postoperative outcomes. 2 In our hospital, TULA is a routine procedure for acute appendicitis or interval appendectomy.…”

“…In complicated appendicitis, no significant differences were observed between the two groups in the length of hospital stay, wound infection, intra-abdominal abscess (IAA), and adhesive intestinal obstruction. 1 Hernandez-Martin et al recommended the TULA procedure for all kinds of appendicitis, although a 32.3% increase in wound complication rate for complicated appendicitis makes surgeons to reconsider this option. 3 Surgeons seem to move away from TULA in cases of complicated appendicitis for the limited operative laparoscopy, since an additional port will be needed.…”

“…3 Surgeons seem to move away from TULA in cases of complicated appendicitis for the limited operative laparoscopy, since an additional port will be needed. 1 Regarding operation time, Perez et al reported that SILA had a longer operative time than conventional laparoscopic appendectomy in a randomized study. 4 Furthermore, Paul et al reported that the SILA procedure had a longer operative time in simple appendicitis than TULA, but a similar operative time in complicated appendicitis.…”