Single Incision Laparoscopic Surgery (SILS) Versus Laparoscopic Appendectomy
Single Incision Laparoscopic Surgery (SILS) Versus Laparoscopic Appendectomy
This is a prospective trial of single incision versus standard 3-port laparoscopic
 appendectomy.

 The hypothesis is that there may a difference in wound infection rates, operative time, doses
 of analgesics post-operatively, and patient/parent perception of scars.
This is a prospective, randomized clinical trial involving patients who present to the
 hospital with non-perforated appendicitis. We will offer enrollment to several institutions
 provided they receive institutional approval.

 There are likely several parameters that will show small differences between groups, and this
 study will precisely quantify them to allow for adequate consultation from surgeons to
 families dealing with acute appendicitis. One theoretical concern over the SILS approach is
 that the exposure of the appendix to the wound could increase the rate of infectious
 complications; therefore, this is the primary outcome variable. The documented rate of
 infectious complications at our institution in patients with non-perforated appendicitis is
 0.6%. An unacceptable and clinically relevant rise to 5% may curtail enthusiasm for the new
 technique. Using a power of 0.9 with an α of 0.05, the sample size is 360 total patients or
 180 in each arm.

 After the procedure, both groups will be managed in the same manner per routine care. They
 will be discharged when tolerating a regular diet and their pain is well-controlled on oral
 pain medication. Cosmetic scores will be obtained at 6 weeks and 6 months.
Inclusion Criteria:

 -  Children under 18 years

 -  Non-perforated appendicitis

 Exclusion Criteria:

 -  Perforated appendicitis as identified as a hole in the appendix for fecalith in the
 abdomen