Lanz Incision for Appendectomy in Pediatric Appendicitis: A Minimally Invasive Open Approach

Abstract Introduction: Laparoscopic access with minimal scar is now sought by parents of pediatric patients, but it requires trained manpower and additional resources. Objectives: The present study aimed to assess the outcomes of Lanz incision and extended Lanz incision for appendectomy in pediatric appendicitis. Materials and Methods: An ambispective study was performed by the author from 2018 to 2023. Our technique (1–2.5 cm incision length) modified the size of the traditional Lanz incision (3–7 cm) with retained skin crease. In patients with technical difficulties, the incision was extended (extended Lanz with 2.5–7.5 cm). Patients managed with Lanz incision and those with extended Lanz were grouped into two comparative groups for statistical evaluation. Student’s t test analyses were used to establish statistical significance (“ P ” value 2.5 to 7.5 cm). All 24 patients with acute appendicitis could be managed with Lanz incision (statistically significant). Out of 47 patients with complicated appendicitis, only 14 were managed with Lanz and 33 with extended Lanz (statistically significant). Conclusion: The Lanz incision easily gives direct access over the cecum guiding to the base of the appendix via the tenia. This approach with modification in the size of the Lanz incision (1–2.5 cm) yields cosmetically better outcomes and superior in approaching the base of the appendix as compared to any other open approach for appendectomy. Our modification in the size of the Lanz incision may be considered a viable option for pediatric appendicitis in a set-up where laparoscopic facilities are unavailable.