%0 Journal Article
%T Laparoscopic Appendectomy in Children: Experience in a Single Centre in Chittagong, Bangladesh
%A Md. Jafrul Hannan
%J Minimally Invasive Surgery
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/125174
%X Background. Since the latter half of 1980s laparoscopy has become a well accepted modality in children in many surgical procedures including appendectomy. We present here the experience of laparoscopic appendectomy in children in a tertiary care hospital in Bangladesh.£¿£¿Subjects & Methods. From October 7, 2005 to July 31, 2012, 1809 laparoscopic appendectomies were performed. Laparoscopy was performed in all the cases using 3 ports. For difficult and adherent cases submucosal appendectomy was performed. Feeding was allowed 6£¿h after surgery and the majority was discharged on the first postoperative day. The age, sex, operative techniques, operative findings, operative time, hospital stay, outcome, and complications were evaluated in this retrospective study. Results. Mean age was 8.17£¿¡À£¿3.28 years and 69% were males. Fifteen percent were complicated appendicitis, 8 cases needed conversion, and 27 cases were done by submucosal technique. Mean operating time was 39.8£¿¡À£¿14.2 minutes and mean postoperative hospital stay was 1.91 days. About 5% cases had postoperative complications including 4 intra-abdominal abscesses. Conclusions. Laparoscopic appendectomy is a safe procedure in children even in complicated cases. 1. Introduction Semm, a German Gynecologist, first described the method of laparoscopic appendectomy in adults [1]. Since then a series of reports came out with restrained enthusiasm for laparoscopy [2¨C6]. In children, the doubts were more pronounced especially in complicated cases [7¨C11]. However practice of laparoscopy increased with passage of time and its superiority over open technique is now well established in terms of morbidity, recovery, wound infections, hospital stay, and utility in young females and obese children [6, 12¨C15]. Nowadays single incision laparoscopy is also being practiced [13]. We describe here our experience with laparoscopic appendectomy in children of Bangladesh using conventional 3 port techniques. 2. Subjects and Methods From October 7, 2005 to July 31, 2012, 1809 laparoscopic appendectomies were performed. Diagnoses were based on clinical suspicion as well as on ultrasonogram findings. Under general endotracheal anesthesia, laparoscopy was performed in all the cases. Patients were supine with monitor on the right side and surgeon on the left side of midsection of patient¡¯s body. Assistant stood on the right side of surgeon towards head-end of patient. Three ports were placed: supraumbilical port for telescope, one port just medial to and below the left anterior superior iliac spine, and another just above and to
%U http://www.hindawi.com/journals/mis/2014/125174/