Appendiceal lesions are common diseases in surgery, and with the progress of society, laparoscopic techniques are becoming more and more common in clinical practice, and laparoscopic appendectomy (LA) is carried out more and more, and three-hole laparoscopic appendectomy has become a safer and more reliable treatment method. In order to pursue the least trauma and the best results, the authors performed two-port laparoscopic appendectomy in some children, which minimized the surgical trauma, reduced the disturbance to the abdominal cavity, recovered the gastrointestinal function quickly after surgery, and significantly shortened the average hospital stay, and effectively reduced the incision infection, intestinal adhesions, intestinal obstruction and other complications after surgery. Surgical method: laparoscopic two-hole appendectomy: the children were anesthetized with intravenous compound anesthesia, and the head was placed in a low-to-high position. 10 mm of skin was incised at the lower edge of the umbilical chakra in the two-hole method, and a pneumoperitoneal needle was inserted at 45° from the incision, and saline was injected; if saline was injected smoothly, the puncture was successful, and an artificial pneumoperitoneum was established, and CO2 was injected at a pressure no higher than 12 mm Hg. A 10-mm casing needle was inserted under direct vision. A 5 mm incision was made at the point of McIlroy and a 5 mm trocar was inserted under direct vision. The appendix is located along the colonic band, and the appendix is examined for adhesions to surrounding tissues. The adhesions are peeled off, the head of the appendix is pulled into the trocar, the abdominal cavity is evacuated, the abdomen is relaxed, the appendix and trocar are lifted out of the abdomen, the appendiceal artery is ligated, and the ligated appendix is severed. The pneumoperitoneum is re-established, the appendiceal stump is placed into the abdominal cavity, the abdominal CO2 gas is evacuated, and the incision is sutured closed. The two-port method of laparoscopic appendectomy is simple and easy to master. At present, endoscopic surgery through the natural channel and transumbilical endoscopic surgery are popular surgical topics, but these two surgical methods require high equipment and technical level, especially the natural channel surgery, which has special requirements for surgical instruments, and the operation needs to go through the natural channel such as stomach and vagina, which is still difficult for most patients to accept psychologically, so it is difficult to promote. The two-hole method laparoscopic appendectomy requires only simple laparoscopic instruments, borrows the extensive and intuitive laparoscopic exploration of the abdominal cavity, and for finding difficult appendices, such as posterior or ectopic appendices, it shortens the operation time greatly. However, the main surgical operations are done under direct vision, therefore, even surgeons with low seniority can easily master the basic laparoscopic techniques as long as they master them, which makes the learning curve shorter and easier to promote than pure laparoscopic surgery. Two-port laparoscopic drag-out appendectomy is suitable for patients with thin body, thin abdominal wall, long appendiceal tract, mild inflammation, no adhesions and normal appendiceal position, while obese patients with thick abdominal wall and difficult appendix presentation and easy postoperative incision infection are not suitable for this surgical approach. The operation must be performed gently, especially for laparoscopic exploration of the ileocecal region and obvious appendiceal congestion and edema, excessive force may cause appendiceal rupture or appendiceal tract tear and bleeding. After the operation, the appendix should be dragged out of the orifice and disinfected to avoid infection of the orifice. The two-hole method of laparoscopic appendectomy is slightly single for the selection of cases, but for laparoscopic surgeons with skilled operating experience, the indications for surgery can be relaxed appropriately. In case of difficult surgical operation, an additional operating orifice can be added at the position of the left Mack’s point, which can be converted to simple laparoscopic appendectomy for laparoscopic suturing, knot tying, mucosal separation and placement of drains to reduce surgical risks. In cases that are really difficult to be completed under laparoscopy, laparoscopic exploration is followed by decisive intermediate open surgery.