Objective:

To assess the clinical effectiveness of a refined single-site two-port laparoscopic suspension method integrated with single-instrument knotting and absorbable clips in pediatric appendectomy, with a specific focus on comparing it to the single-site Hem-o-lok clip approach.

Key Findings:

• 133 pediatric patients included: 70 in absorbable-clip cohort, 63 in Hem-o-lok cohort.
• No significant differences in abdominal drain placement, intraoperative blood loss, or postoperative length of stay (P > 0.05).
• Operative duration was significantly shorter in the Hem-o-lok group (P < 0.05).
• Higher rates of subacute intestinal obstruction and postoperative abdominal pain in the Hem-o-lok cohort (P < 0.05).
• Ultrasonographic follow-up indicated a more robust inflammatory response in the Hem-o-lok cohort.
• Two patients in the Hem-o-lok cohort required reoperation for clip removal due to unmanageable symptoms.

Interpretation:

The modified two-port laparoscopic technique with absorbable clips resulted in fewer complications and a less severe inflammatory response compared to the Hem-o-lok method, despite a longer operative time; these results should be interpreted with caution.

Limitations:

• Retrospective design may introduce bias, including selection bias.
• Small sample size limits generalizability.
• Short follow-up period may not capture long-term outcomes.

Conclusion:

The refined single-site two-port laparoscopic appendectomy with absorbable clips is associated with fewer postoperative complications than the Hem-o-lok method, warranting further validation in larger studies.