https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/de https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/hi https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/ja https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/pt https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/tr https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/fr https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/it https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/ko https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/es https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/zh https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline/de https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline/hi https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline/ja https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline/pt https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline/tr https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline/fr https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline/it https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline/ko https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline/es https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/procedure-outline/zh https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript/de https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript/hi https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript/ja https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript/pt https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript/tr https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript/fr https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript/it https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript/ko https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript/es https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/transcript/zh https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video/de https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video/hi https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video/ja https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video/pt https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video/tr https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video/fr https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video/it https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video/ko https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video/es https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0 https://jomi.com/article/581/single-port-hybrid-open-and-laparoscopic-approach-for-pediatric-appendectomy-for-acute-appendicitis/video/zh https://jomi.com/api/files/0581_Still_Print %281%29.jpg Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis https://fast.wistia.net/embed/iframe/75vwssbjvr https://embed-ssl.wistia.com/deliveries/1eed2b0f6941f46d5f4c1c9dad7b2475.jpg?image_crop_resized=200x120 Single-Port Hybrid Open and Laparoscopic Approach for Pediatric Appendectomy for Acute Appendicitis Acute%20appendicitis%20is%20one%20of%20the%20most%20common%20surgical%20conditions%20in%20pediatric%20patients%2C%20and%20laparoscopic%20appendectomy%20is%20widely%20accepted%20as%20the%20standard%20treatment.%20However%2C%20conventional%20multi-port%20laparoscopic%20techniques%20and%20intracorporeal%20single-port%20approaches%20can%20be%20technically%20demanding%20in%20children%20due%20to%20the%20limited%20intra-abdominal%20working%20space%20and%20instrument%20interference.%0A%0AThis%20case%20involved%20a%204-year%209-month-old%20girl%20presenting%20with%20acute%20abdominal%20pain%20and%20vomiting.%20Ultrasonography%20demonstrated%20appendiceal%20enlargement%20with%20suspected%20appendicolith%2C%20supporting%20the%20diagnosis%20of%20acute%20appendicitis%20and%20indicating%20a%20potential%20risk%20of%20progression%20and%20recurrence.%0A%0ATo%20address%20both%20anatomical%20and%20technical%20considerations%2C%20we%20adopted%20a%20hybrid%20laparoscopic%E2%80%93open%20appendectomy%20using%20a%20single%20umbilical%20incision.%20A%20small%20longitudinal%20incision%20was%20made%20at%20the%20umbilicus%2C%20and%20a%20wound%20protector%20with%20a%20multiport%20cap%20was%20applied.%20Adequate%20exposure%20was%20confirmed%20when%20the%20surgeon%20could%20insert%20an%20index%20finger%20into%20the%20abdominal%20cavity.%20The%20laparoscopic%20component%20was%20limited%20to%20identifying%20and%20grasping%20the%20appendix%2C%20which%20was%20then%20retracted%20and%20exteriorized%20through%20the%20umbilical%20incision.%20Appendectomy%20was%20performed%20extracorporeally%20under%20direct%20visualization%2C%20thereby%20avoiding%20technically%20demanding%20intracorporeal%20maneuvers.%20In%20this%20case%2C%20the%20degree%20of%20inflammation%20was%20mild%2C%20allowing%20smooth%20mobilization%20and%20uncomplicated%20extracorporeal%20removal.%0A%0AThis%20hybrid%20approach%20simplifies%20the%20procedure%20while%20preserving%20the%20advantages%20of%20minimally%20invasive%20surgery%2C%20including%20reduced%20operative%20complexity%20and%20improved%20cosmetic%20outcomes%2C%20and%20represents%20a%20practical%20option%20for%20pediatric%20appendicitis.%C2%A0 1560 yes Diagnostic General Surgery https://jomi.com/articles no Journal of Medical Insight no 2026-06-11T15:00:19.261Z weekly 1.0