Single-Site Laparoscopic-Assisted Appendectomy for Uncomplicated Appendicitis in Children: A Protocolised Approach with Enhanced Recovery and Same-Day Discharge
Anas Shikha1*, Zahraa Zaghloul1, Janice Wong1
1Paediatric Surgery Unit, RIPAS Hospital, Jalan Putera Al-Muhtadee Billah, BA1712 Bandar Seri Begawan, Brunei Darussalam.
*Corresponding Author: Anas Shikha, Paediatric Surgery Unit, RIPAS Hospital, Jalan Putera Al-Muhtadee Billah, BA1712 Bandar Seri Begawan, Brunei Darussalam. ORCID: https://orcid.org/0000-0003-0392-5036
https://doi.org/10.58624/SVOAPD.2025.04.017
Received: September 29, 2025
Published: October 15, 2025
Citation: Shikha A, Zaghloul Z, Wong J. Single-Site Laparoscopic-Assisted Appendectomy for Uncomplicated Appendicitis in Children: A Protocolised Approach with Enhanced Recovery and Same-Day Discharge. SVOA Paediatrics 2025, 4:5, 109-115. doi: 10.58624SVOAPD.2025.04.017
Abstract
Background: Single-site laparoscopic-assisted appendectomy (SLA) is an emerging minimally invasive option for managing paediatric appendicitis. Its integration with enhanced recovery after surgery (ERAS) protocols and same-day discharge remains underexplored in younger children.
Methods: A retrospective review was conducted of children aged 1–12 years who underwent appendectomy at a single centre from January 2020 to December 2024. Patients who received SLA with histologically confirmed appendicitis were included. Outcomes assessed included operative time, complications, postoperative pain control, readmission, and discharge timing.
Results: Of 82 children with appendicitis, 26 underwent SLA and met study criteria. Most operations (73%) were performed by trainees under senior supervision. The mean operative time was 33 minutes. No intraoperative or postoperative complications occurred. Same-day discharge was achieved in 73% of patients, and all recovered with opioid-free analgesia. Readmissions were infrequent and unrelated to surgical issues.
Conclusion: SLA, when implemented within a structured ERAS protocol, is a safe and effective approach for uncomplicated paediatric appendicitis. It enables same-day discharge and facilitates excellent recovery with minimal morbidity. The technique is also suitable for trainee participation under supervision and offers advantages in operative time, cost, and cosmesis.
Keywords: Paediatric appendicitis, Single-site laparoscopic-assisted appendectomy, Minimally invasive surgery, Enhanced Recovery After Surgery (ERAS), Same-day discharge