Background: Laparoscopic appendectomy is the treatment of choice for acute appendicitis. The optimal technique of appendiceal stump closure is still under discussion because it is assumed to affect the occurrence of complications. The three-port combined technique with laparoscopically assisted extracorporeal base ligation (mesoappendix hemostasis performed intra-abdominally and the appendix ligated extra-abdominally) represents a novel technique with which to ligate the appendiceal stump following laparoscopic appendectomy. We compared this combined technique with the appendix stump treatment technique using an endoscopic loop, for complicated and uncomplicated appendicitis. Material and methods: In the period from January 1, 2020 to December 31, 2024, 628 patients under the age of 18 were operated on for appendicitis at the Clinic for Pediatric Surgery of the Clinical Center of the University of Sarajevo, 430(68.5%) with open appendectomy and 198(31,5%) with laparoscopic appendectomy We divided all the patients intotwo groups, group A with 102 patients who underwent surgery with a combined laparoscopic method, and group B where the base of the appendix was closed with an endoscopic loop (95 patients).Results: 198 patients underwent laparoscopic surgery, of which 123 (62%) were boys and 75 (38%) girls. Of these 198 patients who underwent laparoscopic surgery, 102 (52%) were treated using laparoscopically assisted extracorporeal ligation of the base of the appendix, 80 (40%) patients with one endoloop, 15 (8%) with 2 endoloops and only one patient with 1(0.5%) hem-o-lok and an endoloop. Of the 198 patients who were operated laparoscopically, 108 (54%) had complicated appendicitis, 59 (30%) uncomplicated appendicitis and 31 (16%) chronic appendicitis. The average duration of surgery for patients treated with the combined method was 58.61 minutes and with endoscopic loops 69.41 minutes. The average length of hospitalization for patients treated with the combined method was 3.96 days and with endoscopic loops 4.59 days.Conclusions: The three-port combined technique for laparoscopically assisted extracorporeal base ligation of the appendix is a safe, useful, and cost-effective alternative to endoscopic loops, with the advantages of less manipulation, fewer complications involving the appendix, and shorter operative times. This technique is particularly acceptable in resource-limited countries.

We report an infrequent case of a full-term male neonate presenting with a large congenital hernia of the umbilical cord (6 cm × 6 cm) containing only the entire left lobe of the liver. Prenatal ultrasonography suggested an omphalocele; however, the definitive postnatal diagnosis was established based on the presence of a narrow rim of normal skin encircling the umbilical ring and the proximal umbilical cord. Primary closure of the fascial defect was achieved successfully, with no intraoperative or postoperative complications observed. The patient recovered well postoperatively and was discharged in stable condition. Accurate differentiation from an omphalocele is crucial for appropriate management. Unlike omphaloceles, congenital hernias of the umbilical cord (CHUC) typically do not require extensive genetic or cardiac evaluation, and their surgical repair is generally less complex. However, awareness of atypical presentations of CHUC can aid in timely diagnosis, guide surgical planning, and improve clinical outcomes.

The pseudocyst wall is covered with inflammatory fibrotic tissue, unlike true cysts whose wall is covered with mesothelium. Treatment of abdominal pseudocysts involves resection of the pseudocyst wall and shunt replacement. The above procedure can be done by open or minimal access to the surgical procedure. A 10-year-old girl to whom the VPS is placed comes from long-term abdominal colic and symptoms similar to an acute abdomen. We treated the girl with minimal access to the procedure, performed a resection from the abdominal pseudocyst, and did a VPS replacement. The patient’s postoperative course was satisfactory.

Aggressive fibromatosis, also known as desmoid tumor, is a locally invasive soft tissue lesion arising from connective tissues. Reports in children less than 10 years of age is rare. We report a case of a  desmoid tumor located at the middle and lower third of the left rectus abdominis, in a 2-year-old-boy. Partial resection of the muscle segment and simultaneous reconstruction of the abdominal wall by abdominal fascia was done. The patient had an uneventful recovery. At one year of follow-up neither recurrence nor functional or aesthetic complications were seen.