Laparoscopic appendectomy has become the standard approach in most institutions for children with nonperforated appendicitis, and in many institutions for patients with perforated appendicitis. Because of public perception and continued surgical innovation, there has been an impetus to perform operations with fewer and fewer scars, ultimately moving toward "scarless" surgery. Improvements in the laparoscopic technique and instrumentation have led to multiple reports of appendectomy in children being performed by the use of a single-incision approach. Although this approach remains an unproven benefit compared with a traditional laparoscopic appendectomy, the pressures to adopt single-incision appendectomy will continue to increase. This article will review the background of laparoscopy for appendectomy, the introduction of the single-incision approach, available data and outcomes from current literature, and a description of our technique.
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