Transumbilical Laparoscopic-Assisted Appendectomy (TULAA) in Children: A Single-Center Experience of 1597 Cases

Purpose With acute appendicitis remaining the leading cause of emergency surgery among pediatric patients, we aimed to evaluate single centre experience, outcomes and advantages of performed transumbilical laparoscopic-assisted appendectomy (TULAA). Methods A retrospective analysis was conducted of 1,597 consecutive pediatric appendectomies performed between January 2018 and October 2023 at Vilnius University Hospital Santaros Klinikos, Children’s Hospital. Data from patients diagnosed with appendicitis (ICD-10 K35–K36) and treated using ACHI code 30572-00 were included. Demographic, operative, and postoperative parameters were analyzed. Results TULAA was performed in 576 (36.1%) patients. The mean age was 10.7 years; 56.3% were male. The most frequent histological type was phlegmonous appendicitis (74.3%). The appendix was in a typical ileocecal position in 77.8% of cases. Median hospital stay was 3 days. Mean operative time was 40 minutes; higher BMI was associated with longer duration (p = 0.05). The overall complication rate was 1.9%, mainly wound infections. Patients and parents reported high satisfaction with cosmetic outcomes. Conclusions TULAA is a safe, efficient, and cosmetically favorable technique for pediatric appendicitis, associated with a low complication rate and acceptable operative times.