Multiport Laparoscopic Appendectomy Research Articles

A prospective randomized controlled study comparing patient-reported scar evaluation of single-port versus multiport laparoscopic appendectomy for acute appendicitis.

This study aimed to compare the postoperative outcomes and patient-surveyed scar assessments of single-port laparoscopic appendectomy (SPLA) with the outcomes of multiport laparoscopic appendectomy (MPLA). Between August 2014 and November 2017, the prospective randomized study comprised 98 patients diagnosed with acute appendicitis and indicated for surgery. Fifty-one patients had MPLA and 47 patients received SPLA. The primary endpoint was the total score of Patient Scar Assessment Questionnaire (PSAQ) administered to patients 6 weeks after surgery. SPLA involved a shorter median operative time than MPLA (47.5 minutes vs. 60.0 minutes, p = 0.02). There were no apparent differences in the time before diet tolerance, length of hospital stay, and postoperative complication. SPLA patients had shorter total incision length (2.0 cm vs. 2.5 cm, p < 0.01) and required fewer analgesics on the day of surgery than MPLA patients (p = 0.011). The PSAQ favored the SPLA approach, revealing significant differences in total score (48 vs. 55, p = 0.026), appearance (15 vs. 18, p = 0.002), and consciousness (8 vs. 10, p = 0.005), while satisfaction with appearance and symptoms scale did not (p = 0.162 and p = 0.690, respectively). The postoperative scar evaluated by the patient was better with SPLA than with MPLA, and patient satisfaction with the scar was comparable between the two techniques.

Hybrid Appendectomy in Pediatric Appendicitis: A Comparative Analysis of Single-Port and Multiport Laparoscopic Appendectomy.

Background: Hybrid appendectomy (HA) has the technical advantages of the excellent visual field provided by laparoscopic surgery and is fast and easy similar to open surgery. We aimed to compare the safety and effectiveness of HA with single- and multiport laparoscopic appendectomy (SPLA and MPLA) in pediatric patients with acute appendicitis. Materials and Methods: This retrospective study compared the short-term operative outcomes between HA, SPLA, and MPLA groups. From January, 2010 to December, 2019, 239 patients aged <12 years who underwent laparoscopic appendectomy for acute appendicitis were included. The primary outcome was the 30-day postoperative complication rate, stratified according to the modified Clavien-Dindo classification. Results: In 239 patients, HA was more frequently performed in patients with a low body mass index (17.42 versus 18.97 kg/m2 in the SPLA group versus 18.44 kg/m2 in the MPLA group, P = .029) and tended to be more frequently adopted in uncomplicated appendicitis. In uncomplicated appendicitis, the HA group had a significantly shorter operation time than the MPLA group (31.77 versus 40.09 min, P < .001), but had a comparable operation duration with the SPLA group. The rate of 30-day postoperative complications was not significantly different between the groups (HA 7.6% versus SPLA 7.8% versus MPLA 5.4%, P = .841). The postoperative time to resume water intake was significantly longer in the SPLA group than in the HA and MPLA groups (P = .008). Conclusions: HA showed a short operation time, fast functional recovery, and acceptable postoperative complication rate in patients with uncomplicated appendicitis and can be safely and effectively performed in these patients.

Transumbilical Single-Incision Laparoscopic-Assisted Appendectomy (TULAA) Is Useful in Adults and Young Adolescents: Comparison with Multi-Port Laparoscopic Appendectomy.

Background and objectives: Single-port laparoscopic appendectomy (SLA) in most previous studies has used intracorporeal excision of the appendix and needed a longer operative time than multi-port laparoscopic appendectomy (MLA), although SLA does have the potential benefit of an almost invisible scar within the umbilicus. Some studies have reported that extracorporeal transumbilical single-incision laparoscopic-assisted appendectomy (TULAA) in children took a considerably reduced operative time compared to MLA. We adopted TULAA in adults, adding routine dissection of the peritoneal attachment of the appendix. The aim was to compare the operative outcomes between TULAA and MLA. Materials and Methods: Between March 2013 and January 2016, 770 patients with acute uncomplicated and complicated appendicitis from 15 to 75 years of age were enrolled retrospectively. The operation was performed as early (EA) and interval appendectomy (IA). Results: Operative time was shorter in the TULAA group than in the MLA group, except for IA. No open conversion occurred in the TULAA group, except one case of ileocecal resection for IA. No intra-abdominal fluid collection was found in the TULAA group. Extended resection (especially partial cecectomy) was performed less frequently in the TULAA group than in the MLA group for IA. Mean postoperative hospital stay was shorter in the TULAA group for uncomplicated appendicitis. When the data of the EA group and the IA group were compared, operative time was significantly shorter in the IA group for both MLA and TULAA. The open conversion rate and the complication rate tended to be lower in the IA group. Confined to IA, the TULAA group tended to have shorter mean initial, postoperative, and total hospital stays. Conclusions: TULAA can be a useful surgical alternative to MLA in adults and young adolescents, because it lacks open conversion and provides both a shorter operative time and a shorter postoperative hospital stay. TULAA is feasible for IA in that it showed a lower rate of extended resection and complications.

Is single-incision laparoscopic appendectomy suitable for complicated appendicitis? A comparative analysis with standard multiport laparoscopic appendectomy

Despite emerging evidences on the feasibility and efficacy of single-incision laparoscopic appendectomy (SILA) for managing simple appendicitis, advancing its use for treating complicated appendicitis remains unwarranted. This study aimed to evaluate the surgical outcome of SILA compared with that of standard multiport laparoscopic appendectomy (MPLA) in the management of complicated appendicitis. Between July 2013 and September 2017, 40 patients who underwent SILA and 150 patients who underwent MPLA for the treatment of complicated appendicitis, defined as AAST grades II-V, were recruited for this study. The demographic characteristics, intraoperative and recovery parameters were retrospectively recorded. No routine drainage was placed in the SILA group. SILA was smoothly performed without requiring conversion to MPLA. No significant difference was observed between the 2 groups in demography and preoperative severity. The operation duration was approximately 8min shorter in the SILA group than in the MPLA group, without a statistical difference (60.03±21.01 vs. 68.04±32.03min, p=0.222). The recovery parameters, including soft diet intake and postoperative hospitalization, were more favorable in the SILA group (p<0.001). Despite the absence of routine drainage in the SILA group, only 1 patient developed an intra-abdominal hematoma necessitating further computed tomography-guided drainage. SILA is safe and feasible for the management of complicated appendicitis. SILA had non-inferior results to MPLA in terms of time to resume oral intake and postoperative hospital stay. Furthermore, this study posted a question on the concept of routine postoperative drainage in complicated appendicitis.

Evaluation of Single-Incision Multiport Laparoscopic Appendectomy (SIMPLA) Performed with Conventional Equipment

Single-incision laparoscopic surgery (SILS) has emerged as a new method of minimally invasive surgery. SILS appendectomy (SILA) is practiced worldwide, and some studies have proven its cosmetic benefit over conventional three-port laparoscopic appendectomy (CLA) but at higher expense. We evaluate the feasibility of single-incision multiport laparoscopic appendectomy (SIMPLA) with conventional laparoscopic equipment as the perfect cost-effective replacement of both conventional laparoscopic and standard SILA. Since June 2014 to January 2016, total 57 patients underwent SIMPLA. We did a retrospective observational study of the prospectively maintained data of patients who underwent SIMPLA. We have analyzed all the demographic and clinicopathological aspects and reviewed the literature to compare with SILA. The mean operating time was 42.71 ± 5.75 min to perform SIMPLA which is equivalent to SILA with a conversion rate 12.28%. There were minimal intra-operative blood loss, post-operative pain, other peri-operative complications, and length of hospital stay. The mean cosmesis score after SIMPLA was more than eight in post-operative period till the end of 6 months. The cost to perform SIMPLA is much less than SILA in all the patients. The SIMPLA procedure, though it is taking a little higher time than usual, is giving a better cosmesis at a much lower cost which is making this procedure affordable and acceptable in developing countries.

A comparative study between single incision multiport laparoscopic appendicectomy and conventional laparoscopic appendicectomy in tertiary care hospital, Kanchipuram District, Tamil Nadu, India

Background: To compare the outcome of single incision multiport laparoscopic appendectomy versus conventional laparoscopic appendicectomy in terms of patient recovery time, post-operative pain in Karpaga Vinayaga Medical College and Hospital, Kanchipuram District, Tamil Nadu, India.Methods: A randomized control study was done by alternation with sample size of 50 which divided into two groups (study group 25 and control group 25) and study period is from August 2012 to September 2014.Results: Patient in single incision laparoscopy group show less post-operative pain in the first 6 and 12 hours compared to the conventional laparoscopy group, but no difference was noticed between the two groups after 24 hours. No significant difference in operating times was noted between the procedures.Conclusions: One patient in 25 who underwent single incision laparoscopy had wound infection, but no wound complications were noted in the conventional appendicectomy group. Patients underwent Single incision laparoscopy are happier with scar when compared with conventional laparoscopy group. No difference noted in the duration of post-operative hospital stay.

Single-incision laparoscopically assisted appendectomy performed by residents is safe and feasible: A single institution, retrospective case series.

IntroductionTo confirm the safety and feasibility of single-incision laparoscopically assisted appendectomy (SILA) performed by resident doctors.Materials and methodsWe retrospectively analyzed 86 consecutive patients who underwent SILA between August 2010 and August 2016 at Kinki Central Hospital. During this period, 9 residents and 6 board-certified attending surgeons performed SILA. Data on the patients' characteristics and perioperative complications were collected from their medical records.ResultsResident doctors operated on 55% (47/86) of patients undergoing SILA. There were no significant differences between the groups with regard to patient characteristics. Mean operative time in the resident and staff surgeon groups was 74 min and 71 min, respectively (p = 0.5). Median blood loss in both the resident and staff surgeon groups was 0 mL (p = 0.3). The rate of conversion to a different operative procedure was 4% (2/47) in the resident group and 3% (1/39) in the staff surgeon group (p = 1). All three above-mentioned procedures, two (4%, 2/47) in the resident group and one (3%, 1/39) in the staff surgeon group, were converted to multi-port laparoscopic appendectomy. The mean postoperative hospital stay was 5 days for both the resident and staff surgeon groups (p = 0.7). Perioperative complications developed in 9% (4/47) of the patients in the resident group and 21% (8/39) of the patients in the staff surgeon group (p = 0.1).ConclusionsSILA performed by residents under the guidance of a staff surgeon is safe and feasible.

Single-Incision Multi-Port Appendectomy for a Patient with Situs Inversus Totalis: First case report.

Situs inversus totalis (SIT) is a rare autosomal recessive condition involving the complete lateral transposition of the organs. When individuals with this condition suffer from appendicitis, associated pain and symptoms are usually present on the left side, resulting in diagnostic difficulties. Moreover, the laparoscopic removal of the left-sided appendix may pose practical problems during surgery. Removal of an inflamed appendix is generally performed using a multiple-port laparoscopy. We report a 22-year-old male who presented to the Lifeline Institute of Minimal Access Surgery in Chennai, India, in April 2015 with pain in the left iliac fossa. Chest X-rays and ultrasonography confirmed SIT with an acutely inflamed appendix on the left side. The patient underwent a single-incision multi-port laparoscopic appendectomy with a successful outcome. To the best of the authors' knowledge, this is the first report in the literature of a single-incision multi-port appendectomy in a patient with SIT.

Conventional single-port laparoscopic appendectomy for complicated appendicitis in children: Efficient and cost-effective.

BACKGROUND:Laparoscopic appendectomy (LA) is gradually gaining popularity among paediatric surgeons for complicated appendicitis. A retrospective study was conducted to compare conventional single port LA, multiport LA and open appendectomy (OA) for complicated appendicitis in children.PATIENTS AND METHODS:From January 1995 from December 2014, 1,408 patients (604 girls, 804 boys) underwent surgery for uncomplicated and complicated appendicitis. The patient characteristics, operation times, duration of hospitalization, operative costs, and postoperative complications were recorded. A 10-mm 0° scope with a parallel eye piece and an integrated 6 mm working channel were inserted through an 11-mm “conventional umbilical port” for single port LA.RESULTS:A total of 314 patients with complicated appendicitis (128 girls, 186 boys) underwent appendectomy. Among these, 102 patients (32.4%) underwent single port LA, 17 patients (5.4%) underwent multiport LA and 195 patients (62.1%) underwent OA. The hospital stay of the single port LA group was significantly less (3.88 ± 1.1) compared with multiport LA (5.41 ± 1.2) and OA groups (6.14 ± 1.1) (P < 0.001). Drain usage, wound infection and adhesive intestinal obstruction rates were significantly high in the OA group. There was no significant difference between the groups in postoperative intraabdominal abscess formation. Single-port LA performed for complicated appendicitis was cheaper compared with the other groups.CONCLUSIONS:The present study has shown that single-port LA for complicated appendicitis can be conducted in a reasonable operative time; it shortens the hospitalization period, markedly reduces postoperative wound infection and adhesive intestinal obstruction rates and does not increase the operative cost.

An observational study to compare single incision laparoscopic appendectomy with conventional multiport laparoscopic appendectomy

Background: Appendicitis is the most common intra-abdominal condition requiring emergency surgery and it is approached by laparoscopic procedures. Innovative methods were developed that reduce tissue trauma and offer improved cosmetic results, one of such being the single-incision laparoscopic surgery (SILS) with advantages of reduced postoperative morbidity and almost invisible scar. Methods: 60 patients were included in the study after meeting inclusion criteria and divided into two groups 30 each. One group had undergone single incision laparoscopic appendectomy and other with multiple port laparoscopic appendectomy. Preoperative, intraoperative and postoperative parameters were collected. Data involving patients’ demographics, operative time, length of hospital stay and both intraoperative and postoperative complications were collected. Results: The mean duration of surgery in multiple appendectomy was lesser compared to single port appendectomy and values are insignificant (p =0.1844) when compared between the two groups. None of the patients in both the groups did not have any intraoperative complication. Only one patient in single port appendectomy converted to open surgery. The mean postoperative pain VAS score was 2.00 in multiport appendectomy group which was significantly more as compared to 1.60 among single port appendectomy group after 24 hrs. The postoperative complications and the duration of stay in hospital were almost similar in both the groups. The complications observed during follow up in both the cases were minimal and statistically insignificant. Conclusions: The major advantage of SILS is cosmetic satisfaction, while the disadvantages of SILS are longer operative time and higher conversion rate.

A Novel and Scarless Laparoscopic Appendectomy Technique: Two Ports in a Single Incision Plus One Puncture Without Trocar

Single-port laparoscopic appendectomy (SILS-A) is now being performed in a great number of patients. However, SILS-A requires extended operation time and does not markedly decrease postoperative pain or improve cosmesis. To solve these problems, we developed a new technique for laparoscopic appendectomy that relies on 2 ports in a single incision plus 1 puncture (POP-SILS), and we can prove that this useful technique allows SILS-A to be easier and more cosmetic. The cases of 112 patients treated by laparoscopic appendectomy (LA) at our hospital between 2010 and 2013 were studied retrospectively. Forty-one were cases of locally complicated appendicitis, and 71 were cases of simple appendicitis. In laparoscopic appendectomy with POP-SILS, we maintain instrument triangulation using two 5-mm ports in the umbilicus and needle instruments that are introduced by puncture above the pubic bone. We studied the safety and usefulness of this method from the standpoint of operation time, postoperative stay, and complications. From 2010 to 2013, we performed 77 POP-SILS-LAs. Thirty-five patients required 1 or more additional ports or underwent conventional LA. The time required for POP-SILS-LA was 54 minutes (range, 23–209) in cases of simple appendicitis. Even in 17 cases of locally complicated appendicitis, POP-SILS-LA was successful. There was no statistical difference in surgical complications between POP-SILS-LA and multiport LA. Both the umbilical scar and the puncture scar eventually became invisible. The outcomes in our patient series showed POP-SILS-LA to be a safe and beneficial, minimally invasive approach to laparoscopic appendectomy.

The Influence of Training Levels and Surgical Experience on Outcomes after Single-Incision Laparoscopic Appendectomy

Background: Single-incision laparoscopic appendectomy (SILA) has become an accepted alternative to conventional multiport laparoscopic appendectomy. Yet, little is known about the impact of operations performed by residents on the outcome of SILA. The aim of the present study was to evaluate the safety and efficacy of SILA performed by younger surgeons. Methods: All SILA's at a single institution were reviewed and grouped according to the educational level of the operating surgeon: group 1 included residents with no experience in single-incision laparoscopic surgery (SILS) and little experience in multiport laparoscopy, group 2 comprised fellows with experience in multiport laparoscopy but with no experience in SILS, and group 3 consisted of senior surgeons, all of whom were experienced in performing SILS. Results: A total of 176 patients were included. The patients had been operated on by residents (n=62), fellows (n=21), or senior surgeons (n=93). Senior surgeons performed the operation in less time than fellows or residents (48.7 vs. 55.4 vs. 53.6 minutes, respectively; p=0.108). Six patients required conversion to multiport laparoscopy while no patient required conversion to the open procedure. The overall postoperative morbidity was 9.1%, with no significant difference between the three groups (p=0.536). The surgeon's level of surgical education was no statistical risk factor for developing postoperative complications after SILA. Conclusion: Although operating times were longer for residents and fellows compared to senior surgeons, less surgical experience did not correlate with a greater need for conversion to multiport laparoscopy and was not associated with a higher rate of postoperative complications.

Single Incision versus Conventional Multiport Laparoscopic Appendectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: The efficacy of single incision laparoscopic appendectomy (SILA) in comparison with conventional multiport laparoscopic appendectomy (CMLA) has not been conclusively determined. Methods: A systematic literature review (Medline, EMBASE, Science Citation Index, and Cochrane Central Register of Controlled Trials) was performed. Meta-analyses of randomized controlled trials (RCTs) comparing SILA with CMLA were carried out by RevMan 5.0 software. Results: Eleven RCTs comparing SILA and CMLA were included. Overall, 1,216 patients were operated on: 611 cases by SILA versus 605 cases by CMLA. Compared with CMLA, SILA was associated with increased procedural difficulty, prolonged procedural duration, shorter length of hospital stay, earlier return to normal activity and better cosmesis. There were no significant differences in postoperative pain scores and complication rates between SILA and CMLA. Conclusion: The current best evidence shows SILA holds the promise of improving postoperative recovery and cosmetic result with equal efficacy and safety, whereas it is associated with higher surgical difficulty with longer surgical time when compared with CMLA.

Transumbilical laparoscopic-assisted appendectomy is associated with lower costs compared to multiport laparoscopic appendectomy

Background/PurposeSingle-incision laparoscopic appendectomy has been associated with improved cosmetic benefits, and decreased postoperative pain. Less is known about costs and other outcomes. Our aim was to evaluate the costs and outcomes between transumbilical laparoscopic-assisted appendectomy (TULAA) and multiport laparoscopic appendectomy (MLA). MethodsIRB-approved retrospective review (September 2010–July 2013) of institutional medical records identified 372 pediatric patients undergoing laparoscopic appendectomy. Outcomes included costs, LOS and readmission. Costs were fully loaded operating costs from the hospital’s cost accounting database. Generalized linear regression was used to assess costs of MLA and TULAA. A subgroup analysis was performed using only patients with non-perforated appendicitis. ResultsThere were 132 patients (35.5%) that underwent TULAA while 240 patients (65.5%) underwent MLA. Compared to MLA, TULAA was associated with decreased operative time (0.6 vs. 1.0h, p<0.0001), used in comparable proportions of interval appendectomies, but was performed less often for perforated appendicitis (9.8% vs. 22.9%, p=0.002). Readmission and postoperative complications were similar between both groups. In the setting of non-perforated appendicitis, TULAA was associated with lower costs of $1378 relative to MLA (p=0.009). ConclusionsIn non-perforated appendicitis, TULAA is associated with lower costs and comparable rates of readmission and postoperative complications.

Single-incision laparoscopic appendectomy versus traditional three-port laparoscopic appendectomy: an analysis of outcomes at a single institution

Questions have emerged as to whether single-incision laparoscopy has reproducible or superior patient outcomes compared with traditional laparoscopy. A retrospective review comparing single-incision laparoscopic (SILS) appendectomy and traditional multiport laparoscopic (MP) appendectomy was conducted to assess the safety and feasibility of the less invasive laparoscopic technique. All SILS and MP appendectomies performed by three surgeons at a single institution during 43months were reviewed. Statistical evaluation included descriptive analysis of demographic data including age and gender, as well as bi- and multi-variate analyses of operative outcomes including operative time, conversions, complications, and hospital length of stay. The study reviewed 168 patients who underwent SILS appendectomy and 108 patients who underwent MP appendectomy. No statistically significant difference was found between the mean SILS and MP operative times (43.63 vs. 40.95min; p=0.29). Additionally, no statistically significant association was noted between surgical approach and length of hospital stay. Although 0.93% of MP appendectomies and 2.38% of SILS appendectomies were converted to open procedure, this difference was not statistically significant (p=0.65, Fisher's exact test). After exclusion of cases converted to open procedure from the study, the findings showed that 3.66% of SILS cases were converted to multiport laparoscopy. No increase in the overall complication rate was associated with SILS compared with MP appendectomy. The wound complications documented included one incisional hernia for SILS appendectomy and two wound infections for MP appendectomy. The findings showed SILS appendectomy to be a safe and feasible alternative to traditional MP appendectomy that can be conducted with operative times, lengths of stay, and complication rates similar to those of the standardized technique. This review is a precursor to prospective studies, which are warranted to demonstrate conclusively the equivalence of operative times, complications, and lengths of hospital stay, as well as to elucidate differences in patient-centered outcomes including postoperative pain, cosmesis, and quality of life.

Single-incision laparoscopic-assisted appendectomy in children: exteriorization of the appendix is a key component of a simple and cost-effective surgical technique

Single-incision laparoscopic appendectomy was recently introduced as a less-invasive surgical technique than existing methods, and is increasingly being performed worldwide. We have started to perform transumbilical laparoscopic-assisted appendectomy (TULAA) in children. In this study, we assessed its feasibility, efficacy, and cost-effectiveness compared with conventional multiport laparoscopic appendectomy (MLA). We retrospectively reviewed all of the patients who underwent MLA or TULAA between August 2009 and December 2012. Patient characteristics, operative time, length of hospital stay, postoperative complications, cost-effectiveness, and cosmetic results were analyzed. A total of 88 patients underwent laparoscopic appendectomy, with MLA in 48 patients and TULAA in 40 patients. TULAA was successful in 36/40 patients. There were no significant differences in mean operative time or mean length of stay between the two groups of patients. There were no postoperative complications in the TULAA group. The cost of TULAA was much lower than that of MLA. TULAA also provided nearly scarless surgery. TULAA, in which the appendix is exteriorized via a combination of open and laparoscopic techniques, is a safe and effective procedure for treating appendicitis in children. TULAA is a cost-effective treatment that provides excellent cosmetic results.

Single-incision multi-port laparoscopic appendectomy: How I do it

INTRODUCTION:Single-incision laparoscopic surgery (SILS) appendectomy seeks to further minimise the trauma of parietal access of laparoscopic appendectomy.METHODS:We present our initial experience of 17 cases of SILS appendectomy which were completed using conventional laparoscopic instruments. We utiliesd a single-incision multi-port laparoscopic appendectomy (SIMPLA) technique.RESULTS:The operative time was 63 ± 20 min, blood loss 6.5 ± 5 mL, bowel movement (passing stool) occurred in 2.6 ± 0.6 days. Most patients were discharged on the first operative day on oral diet. The analgesic usage and pain scores were similar to multi-port laparoscopic appendectomy. No complications were noted at follow-up till 4 weeks and the surgical wound healed in all patients with an inconspicuous scar.CONCLUSION:Our initial experience with SILS appendectomy demonstrates its feasibility and supports the promise of minimising further the access of laparoscopic surgery. The clear advantage is its cosmetic benefit.

Single-incision laparoscopic appendectomy vs multiport laparoscopic appendectomy in children: a retrospective comparison

Background Minimally invasive surgery is commonly used to treat appendicitis. Single-incision laparoscopic surgery is an attractive modality to treat a commonly occurring problem with the advantage of minimal or possibly no scarring. We sought to compare our results of single-incision laparoscopic appendectomy (SILA) with those of patients undergoing traditional multiport laparoscopic appendectomy (MPLA). Patients and Methods A retrospective review of all patients who underwent a minimally invasive appendectomy from September 2009 to February 2010 was performed. The patients were divided into 2 groups based on if they had a SILA or a traditional MPLA. Outcomes including demographics, diagnosis, operative time, length of stay, narcotic usage, and complications were evaluated. Results A total of 110 patients underwent appendectomy. There were 50 patients who underwent SILA and 46 patients who underwent MPLA. Fourteen patients with perforated appendicitis were excluded. Mean age (11.1 vs 11.7 years, P = .43), weight (43.3 vs 50.9 kg, P = .27), and length of stay (1.1 vs 1.2 days, P = .56) were comparable between both groups. Operative time for SILA was slightly longer (33.8 vs 26.8 minutes, P = .01). Overall intravenous narcotic use was lower in the SILA group (0.9 vs 1.4 doses, P = .01), but there was no difference in the patients who also received ketorolac (0.8 vs 1.0 doses, P = .6). Four patients in the SILA group developed superficial wound infections and 1 patient in the SILA group was admitted for postoperative abscess. Conclusions Single-incision laparoscopic appendectomy is safe and effective in the pediatric population. Further studies should be performed to determine the impact on operative time and postoperative narcotic requirements.