Appendectomy is a common surgical procedure in children.  Laparoscopic appendectomies (i.e., procedures requiring an incision only large enough to introduce a laparoscope and then excision of the appendix using the laparoscope) have been performed by pediatric surgeons.  It is thought that laparoscopic appendectomies may cost more than conventional “open appendectomies” because they use disposable instruments and have longer operating time.  In Finland, 87 children (ages 4-15) who had an urgent appendectomy were studied.  Cost of supplies, operating room use, costs of hospitalization during recovery, and costs of recovery after discharge were evaluated.  Patients were randomized to receive either a laparoscopic or open appendectomy.

It was found that laparoscopic procedure itself was more expensive than the conventional surgery.  But the increased operating costs were offset somewhat by a shorter hospital stay.  Laparoscopic appendectomy is marginally more expensive, but allowed children to return earlier to normal daily activities. 

(Lintula H, et al.  Arch Pediatr Adolesc Med 2004; 158:34-37.) 

Comment:  This study is from Finland, but laparoscopic appendectomies are also beginning to be done in the USA.  And they also finding some clear advantages to this procedure here, too.     - H.T.