Laparoscopic appendectomy in children: sense or nonsense?

The authors present a retrospective analysis of their first 1.500 paediatric laparoscopic appendectomies. Three types of techniques (OUT, MIXED, IN) are described. The average age of the patients was 8 years (range: 2 to 16 years). In case of acute appendicitis the postoperative complication rate was 0.6%. In case of peritonitis the postoperative complication rate raised to 13.3%. Conversion rate was 3.3%. There were no death. Mean hospital stay was 1.8 days for acute appendicitis and 6.5 days for peritonitis. Laparoscopic appendectomy in children has an unquestionable diagnostic interest, decreases the parietal complications and has a better cosmetic result in case of peritonitis or ectopic appendicitis. Benefits are highest in case of peritonitis by decreasing postoperative pain and length of hospital stay. The teaching value for learning laparoscopic surgeons is obvious. Increase of intraperitoneal residual abscesses, as well as increasing cost, remain controversial. This series is a plea for laparoscopic appendectomy in children.