ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Gastroenterology, Hepatology and Nutrition
Transumbilical Laparoscopic-Assisted Appendectomy (TULAA): A Feasible Minimally Invasive Option for Pediatric Acute Appendicitis with Comparable Outcomes to Three-Port Laparoscopic Appendectomy (TPLA)
Longgang District Maternity & Child Healthcare Hospital of Shenzhen City, Shenzhen, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract
Objective:This study aimed to compare the safety and feasibility of transumbilical laparoscopic-assisted appendectomy (TULAA) versus three-port laparoscopic appendectomy(TPLA) for the treatment of acute appendicitis in children. Materials and methods:A retrospective analysis was conducted on pediatric patients who underwent appendectomy at Maternity&Child Healthcare Hospital of Longgang District, Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College) between January 2022 and June 2025. Patient demographics, operative times, postoperative recovery parameters (time to first flatus, length of hospital stay), and complication rates were compared between the two surgical groups. Results:A total of 171 patients were enrolled in the study, with 109 cases in the TULAA group and 62 cases in the TPLA group. There were no significant differences between the TULAA and TPLA groups in baseline characteristics including age, gender, weight, height, BMI, white blood cell count, or CRP levels (p>0.05). The mean operative time was comparable between groups (TULAA: 54.94±24.97 min vs. TPLA: 58.65±25.58 min, p=0.356). However, the TULAA group demonstrated a significantly shorter average hospital stay (4.83±1.53 days vs. 5.35±1.19 days, p=0.022). Conversely, the time to first postoperative flatus was significantly longer in the TULAA group (25.81±11.00 hours vs. 21.13±10.01 hours, p=0.006). The overall complication rate showed no significant difference (TULAA: 4.6% vs. TPLA: 6.5%, p>0.05), with all cases managed conservatively. Conclusion:For pediatric acute appendicitis, TULAA is a safe and feasible minimally invasive technique, resulting in a significantly reduced hospital stay compared to TPLA despite a slightly delayed return of bowel function. Both techniques demonstrate comparable operative times and overall complication rates. TULAA represents a valuable surgical option within the pediatric minimally invasive arsenal.
Summary
Keywords
acute appendicitis, Children, Laparoscopic appendectomy, Minimal invasive surgery, Transumbilical laparoscopic-assisted appendectomy
Received
14 October 2025
Accepted
20 February 2026
Copyright
© 2026 Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Yifan Li
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.