Laparoscopic appendectomy in children : Sense or nonsense?

The authors present a retrospective analysis of their first 1.500 paediatri c laparoscopic appendectomies. Three types of techniques (OUT, MIXED, IN) a re described. The average age of the patients was 8 years (range: 2 to 16 y ears). In case of acute appendicitis the postoperative complication rate wa s 0.6%. In case of peritonitis the postoperative complication rate raised t o 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. Laparosco pic appendectomy in children has an unquestionable diagnostic interest, dec reases the parietal complications and has a better cosmetic result in case of peritonitis or ectopic appendicitis. Benefits are highest in case of per itonitis by decreasing postoperative pain and length of hospital stay. The teaching value for learning laparoscopic surgeons is obvious. Increase of i ntraperitoneal residual abscesses, as well as increasing cost, remain contr oversial. This series is a plea for laparoscopic appendectomy in children.