How is pediatric appendicitis treated? Once diagnosed, pediatric appendicitis should be actively treated surgically. Pediatric appendicitis progresses relatively quickly and is highly susceptible to bad bureaucracy and perforation. Treatment is divided into conservative treatment and surgical treatment. At present, all cases should be treated surgically except those with more than three days of onset and significant improvement of symptoms. Early surgical treatment is currently advocated. There are almost no complications and sequelae after surgery for simple appendicitis, but gangrenous and perforated appendicitis often has more complications and sequelae, such as incisional infection, intestinal adhesions, intestinal obstruction, abdominal residual abscesses, etc. In mild cases, the course of the disease is prolonged, and in severe cases, reoperation may be required. Can pediatric appendicitis be treated laparoscopically? There are two types of surgical treatment: traditional open surgery and laparoscopic surgery. Minimally invasive laparoscopic surgery is generally considered to be the best option. The advantages of laparoscopic treatment of pediatric appendicitis include minimally invasive, fast recovery, and cosmetic features, in addition to many other advantages that traditional surgery does not have. What are the advantages of laparoscopic surgery for pediatric appendicitis? 1, abdominal drainage of pus is clean, thorough and convenient. The laparoscope can observe any location of the abdominal cavity or pelvic cavity, and if there is pus, it can be immediately aspirated, while it can be thoroughly flushed. Traditional surgery cannot do this through a right lower abdominal incision and often causes residual abscesses in the abdominal and pelvic cavities, which are very difficult to deal with. Residual abscesses of the abdominal and pelvic cavities after laparoscopic surgery are very rare. 2, Incisional infection is rare. After laparoscopic appendectomy, the appendix is removed from the trocar in a specimen bag, and the gangrenous perforated appendix does not touch the incision, thus avoiding incisional contamination, which proves that the incisional infection rate of laparoscopic appendectomy is extremely low. On the contrary, the incisional infection rate of conventional method appendectomy is higher. Because the pus and appendix are removed from the right lower abdominal incision, the incision is inevitably contaminated. Although some preventive and treatment measures can be taken, the incision infection rate is still higher compared with laparoscopic surgery. 3, obese children are more suitable for laparoscopic surgery: the fatter the child, the thicker the abdominal wall, the larger the traditional surgical incision will be, otherwise it is difficult to operate, laparoscopic surgery is not, not affected by the thickness of the abdominal wall, regardless of pediatric fat and thin are 4-5 mm incision. 4, the heavier the appendicitis the more suitable for laparoscopic surgery: the heavier the appendicitis the more intra-abdominal exudate may be, the heavier the adhesions, the more obvious the laparoscopic surgery, some doctors abroad in the traditional appendectomy surgery encountered difficulties when turned to laparoscopic surgery, thus showing the advantages of laparoscopic surgery. 5, the exploration of other organs of the abdominal cavity is very convenient. Some children already have full peritonitis when they go to the doctor, it is difficult to determine whether it is caused by appendicitis or other lesions such as Meckel’s diverticulitis, etc. Traditional surgery can only take an exploratory incision, which is very damaging, but laparoscopic surgery is not only less damaging, but also clear at a glance, which is particularly convenient to deal with. 6, can deal with other lesions. Hernia, syringomyelia, etc. . I heard that the laparoscopic surgery for pediatric appendicitis is divided into 1, 2 and 3 holes? As the name implies, the appendix is removed through 1, 2 or 3 holes. The classical laparoscopic appendectomy is a three-hole approach, which is suitable for any type of appendicitis. Later, when laparoscopes with operating channels were invented, the single-port method of appendectomy emerged. Appendicitis surgery has been performed with a plain laparoscope through 2 holes, similar in principle to the single-port approach. Others use a laparoscope with an operating channel to perform appendicitis through 2 holes, similar in principle to the 3-hole method. Each has its own unique features. Each of the three surgical methods has its own indications and is also limited by the proficiency of the instruments and personnel in laparoscopic techniques. In our hospital, the single-port approach is generally used for appendicitis with mild inflammation and no adhesions, while the three-port or two-port approach is used for other types of appendicitis. Does early or late surgery after appendicitis have an impact on the recovery of a child? Yes, it does. Simple appendicitis has few complications and sequelae after surgery, but gangrenous and perforated appendicitis often has more complications and sequelae, such as incisional infection, intestinal adhesions, intestinal obstruction, and abdominal residual abscesses. In mild cases, the course of the disease is prolonged, and in severe cases, reoperation may be required. Is all appendicitis laparoscopic? In terms of the disease itself, laparoscopic treatment of all types of appendicitis should not be a problem. However, there are some limitations, such as the availability of laparoscopic equipment and instruments, and the proficiency of the physician in laparoscopic techniques. In our hospital, the youngest patient with appendicitis was 6 months old, and the most serious one was a 7-day-old periappendiceal abscess treated laparoscopically with satisfactory results.