Acute appendicitis is one of the most common surgical emergencies in children. Traditionally, appendectomy has been regarded as the standard treatment; however, increasing evidence supports non-operative management (NOM) for selected cases of uncomplicated appendicitis and as an initial strategy for complicated appendicitis presenting with abscess or phlegmon. The role of interval appendectomy (IA), defined as the elective removal of the appendix weeks after successful NOM, remains controversial. Historically, IA was routinely recommended to prevent recurrent appendicitis and to exclude underlying pathology. More recent evidence has challenged this practice, highlighting relatively low recurrence rates after successful NOM, advances in imaging and follow-up protocols, and the morbidity and costs associated with additional surgery. This review examines the current evidence regarding IA in children following NOM for both complicated and uncomplicated acute appendicitis. The literature suggests that routine IA may not be necessary in all children after successful NOM. While certain subgroups, particularly those with appendicoliths, persistent symptoms, or recurrent disease, may benefit from interval appendectomy, a selective rather than routine approach appears increasingly justified. Shared decision-making involving children, parents, and clinicians is essential when balancing the risks of recurrence against the morbidity and costs of surgery.

Background: Basal cell carcinoma (BCC) is the most frequent non-melanoma skin malignancy globally, typically characterized by slow, locally invasive growth with a low propensity for distant metastasis. Among its distinct histopathological variants, the adenoid variant of nodular BCC is a relatively uncommon presentation that can mimic glandular structures or other cutaneous adnexal tumors. Case Presentation: We present the case of a 53-year-old female who presented with a blackish, warty, nodular, ulcero-proliferative growth measuring 2.2 x 2cm, located 2 cm lateral to the right angle of the mouth, evolving over 2 years. The patient had a relevant medical history of long-standing epilepsy and recently diagnosed diabetes mellitus. Local examination revealed classic BCC features, including central depression, a beaded appearance, and rolled-out edges. A wide local excision was performed via a curvilinear elliptical incision aligned with the right nasolabial fold, achieving clear surgical margins. Histopathological evaluation confirmed a nodular basal cell carcinoma with prominent adenoid (cribriform and cystic) differentiation, characterized by peripheral palisading and retraction clefts. The postoperative period was uneventful, and primary closure yielded excellent cosmetic results. Conclusion: The adenoid variant of nodular BCC represents a unique histopathological subtype. Wide local excision with adequate oncological margins remains the cornerstone of treatment, providing excellent long-term prognosis and exceptional local control.

Appendectomy remains one of the most performed emergency surgical procedures worldwide. A critical step in laparoscopic appendectomy is the secure closure of the appendicular stump, which prevents postoperative complications such as stump leak, intra-abdominal abscess, and stump appendicitis. Over the past few decades, numerous techniques for stump closure have evolved, ranging from simple ligature methods to advanced mechanical devices, such as staplers, clips, and endo loops. Each technique offers distinct advantages in terms of safety, cost-effectiveness, operative time, and ease of use. With the widespread adoption of minimally invasive surgery, laparoscopic appendectomy has introduced additional modalities, including clips, energy devices, and intracorporeal suturing. This review aims to critically evaluate various appendicular stump closure techniques in the context of acute appendicitis. Key considerations include clinical outcomes, complication rates, and cost implications. Although no single technique is universally superior, current evidence suggests that secure closure tailored to intraoperative findings and resource availability remains paramount.

Laparoscopic cholecystectomy (LC) and Total Extraperitoneal (TEP)/Transabdominal Preperitoneal (TAPP) repair have established themselves as standard and popular surgeries for gallstone disease and groin hernia, respectively. However, their concurrent performance for co-existing gallstone disease and groin hernia has seldom been studied. This retrospective observational study was conducted at the Department of General and Laparoscopic Surgery, Dr. L H Hiranandani Hospital, Mumbai, India, from March 2008 to July 2025. Over 18 years, 24 patients with co-existing gallstone disease and primary or recurrent groin hernia underwent concurrent LC and TEP/TAPP repair in a single sitting. The outcomes studied included duration of surgery, intra- and postoperative complications including mesh infection, duration of hospital stay, hernia recurrence, time to resume normal activity, and treatment cost. The mean age of the patients was 66 ± 9.7 years (range 50–87 years), and the average duration of surgery was 55 ± 10 minutes (range 40–75 minutes). There was no conversion to open surgery. The mean postoperative hospital stay was 1.5 ± 0.5 days. Four (16.67%) patients developed small seromas on day 10, all of which resolved with conservative management within six weeks. No patient experienced significant haemorrhage, superficial or deep surgical site infection, mesh infection, or hernia recurrence. Patients resumed normal activity within an average of 5 days. Concurrent treatment reduced the total cost by 25% compared to performing both procedures separately. These findings suggest that concurrent LC and TEP/TAPP is a safe, practical, and cost-effective procedure in carefully selected patients.

Background: Acute appendicitis is one of the most quotidian surgical emergencies worldwide, accounting for a large share of emergency admissions. Despite modern lab tests and imaging, diagnosis often remains uncertain, leading to complications, delays, or unnecessary surgery. Emerging tools like machine learning and deep learning are helping improve accuracy and decision-making. Objective: This review explores how artificial intelligence (AI) including machine learning and deep learning, is being used in diagnosing and managing acute appendicitis. Evidence shows AI models often outperform traditional scoring systems like Alvarado and AIR (Appendicitis Inflammatory Response), offering greater accuracy, fewer unnecessary surgeries, and stronger support for clinical decision-making and future integration. Methods: This narrative review was conducted to synthesize current evidence on the role of artificial intelligence in acute appendicitis. A structured literature search was performed using Google Scholar, PubMed, Scopus, and Web of Science, covering publications from January 2010 to December 2025. Case reports, editorials, and non‑English language articles were excluded. Results: AI can now read computed tomography (CT) scans as effective as radiologists and tell simple from complex appendicitis. In children, using AI with ultrasound can reduce the need for CT scans. Research suggests AI can also predict perforation risk, outcomes, and who might be managed without surgery. But before AI is widely used, it still needs strong testing, smooth fit into daily practice, and methodical ethical reviews. Conclusion: AI shows great potential in the management of patients with appendicitis, but robust multicenter trials and integration into surgical workflows are needed before widespread adoption.

Acute appendicitis remains one of the most common surgical emergencies worldwide, traditionally managed by open or laparoscopic appendectomy. Over the past two decades, minimally invasive techniques have evolved significantly, culminating in the development of Natural Orifice Transluminal Endoscopic Surgery (NOTES). NOTES Appendectomy represents an innovative approach that eliminates abdominal incisions by accessing the peritoneal cavity via natural orifices such as the trans gastric or transvaginal route. This review aims to synthesize current evidence on NOTES appendectomy in the management of acute uncomplicated appendicitis, focusing on feasibility, safety, clinical outcomes, advantages, limitations, and future directions. Existing literature suggests that NOTES appendectomy is technically feasible and provides potential benefits in terms of reduced postoperative pain, improved cosmetic outcomes, and faster recovery. However, challenges related to technical complexity, infection risk, limited instrumentation, and learning curve persist. While hybrid NOTES techniques combining laparoscopic assistance have shown promising results, pure NOTES appendectomy remains largely experimental. This review highlights the current state of NOTES appendectomy and emphasizes the need for standardized protocols and long-term outcome evaluation.

Acute appendicitis is one of the most common surgical emergencies worldwide, with laparoscopic appendectomy increasingly regarded as the gold standard treatment. Since its introduction in the late 20th century, laparoscopic surgery has transformed the management of appendicitis by offering reduced postoperative pain, shorter hospital stays, earlier return to normal activities, and improved cosmetic outcomes. This review examines the current evidence regarding the role of laparoscopic appendectomy in the surgical management of acute appendicitis in adults, children, and the elderly. Evidence suggests that laparoscopic appendectomy is superior in many clinical scenarios, although surgeon expertise and institutional resources remain critical determinants of outcomes.