{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:05:17Z","timestamp":1777921517615,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>We are presenting a very minimally invasive technique for laparoscopic appendectomy (needlescopic appendectomy [NAP]) in children and adolescents using suture grasper device, epidural needle, and homemade isolated long diathermy probe without any conventional laparoscopic instruments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>NAP was attempted in 48 patients with uncomplicated acute appendicitis at Al-Azhar, Tanta University Hospitals and other allied hospitals during the period from May 2017 to November 2018. The study included patients with acute appendicitis and patients scheduled for interval appendectomy. Exclusion criteria were patients with concealed appendix, patients with appendicular abscess or appendicular mass, patients with acute appendicitis complicated with generalized peritonitis, and patients unfit for laparoscopy. The appendix was brought outside through the umbilical port and the operation was completed extracorporeally. In cases of appendicitis with tethered cecum, the whole procedure was completed intracorporeally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Forty-eight patients with acute uncomplicated appendicitis were treated by NAP. They were 36 males and 12 females with a mean age of 9\u2009\u00b1\u20093.7 years (range\u2009=\u20094\u201315 years). Two cases with concealed appendix and one case with appendicular mass were diagnosed during initial laparoscopy and excluded from the study. Thirty-two cases (71.11%) were completed intracorporeally and 13 cases (28.89%) were completed by extracorporeal NAP. The mean operative time was 33.29\u2009\u00b1\u20093.95 minutes (range\u2009=\u200927\u201340 minutes) for intracorporeal NAP and 20.9\u2009\u00b1\u20097.01 minutes (range\u2009=\u200914\u201340 minutes) for extracorporeal NAP. Degrees of cosmetic satisfaction of the patients and parents were excellent in 93.33% (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200942\/45 patients), and very good in 6.67% (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u20093\/45 patients) of patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>NAP using needles only is a new technique that is very minimally invasive, very cheap, safe, reproducible, and easy to be done with outstanding cosmetic results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lap.2020.1011","type":"journal-article","created":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T12:16:01Z","timestamp":1614687361000},"page":"497-504","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Needlescopic Appendectomy in Children and Adolescents Using 14-Gauge Needles: A New Era"],"prefix":"10.1177","volume":"31","author":[{"given":"Rafik","family":"Shalaby","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Al-Azhar University Hospitals, Cairo, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed I.","family":"Elsawaf","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Tanta University Hospital, Tanta, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soliman","family":"Mohamad","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Al-Azhar University Hospitals, Cairo, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashraf","family":"Hamed","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Al-Azhar University Hospitals, Cairo, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Mahfouz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Al-Azhar University Hospitals, Cairo, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2016.09.087"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.4174\/jkss.2010.78.4.213"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1063473"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2015.10.002"},{"key":"e_1_3_4_6_2","first-page":"105","article-title":"Two-port laparoscopic appendectomy with the help of a needle grasper: Better cosmetic results and fewer trocars than conventional laparoscopic appendectomy","volume":"11","author":"Donmez T","year":"2016","unstructured":"Donmez T, , Sunamak O, , Ferahman S, et al. Two-port laparoscopic appendectomy with the help of a needle grasper: Better cosmetic results and fewer trocars than conventional laparoscopic appendectomy. Wideochir Inne Tech Maloinwazyjne, 2016; 11:105\u2013110.","journal-title":"Wideochir Inne Tech Maloinwazyjne"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2019.0299"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2017.08.020"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.02.082"},{"key":"e_1_3_4_10_2","first-page":"153","article-title":"Experience with early operative interference in cases of disease of the vermiform appendix","volume":"26","author":"McBurney C","year":"1969","unstructured":"McBurney C. Experience with early operative interference in cases of disease of the vermiform appendix. 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