A new camera-tube surgical technique successfully treated 94% of children with appendicitis without removing the appendix, according to Gram Research analysis of a 2025 study of 47 children. However, 12% developed appendicitis again within 7.8 months and required traditional surgery, suggesting this minimally invasive approach works initially for most kids but carries a meaningful recurrence risk that families should discuss with their doctors.
Researchers in China tested a new minimally invasive surgical technique using a special camera tube to treat appendicitis in children without surgery to remove the appendix. In a study of 50 kids with acute appendicitis, 94% were successfully treated using this method, called cholangioscope-assisted endoscopic retrograde appendicitis therapy (ERAT). Kids went home after about 4 days on average, and most stayed healthy during the 7.8-month follow-up period. However, 6 children (12%) developed appendicitis again and needed traditional surgery. The findings suggest this tube-based approach could be a safe alternative to removing the appendix in some cases, though more research is needed.
Key Statistics
A 2025 study of 50 pediatric patients found that cholangioscope-assisted endoscopic retrograde appendicitis therapy successfully treated 94% of children with acute uncomplicated appendicitis without removing the appendix, with an average hospital stay of 3.96 days.
Among 47 children successfully treated with the tube procedure in a 2025 study, 12% (6 children) developed recurrent appendicitis within an average follow-up period of 7.8 months and subsequently required surgical appendectomy.
A 2025 analysis of 50 pediatric appendicitis cases found that poor liquid diet tolerance in the first 12 hours after the tube procedure and narrowing of the appendix opening were significantly associated with appendicitis recurrence.
The cholangioscope-assisted endoscopic retrograde appendicitis therapy procedure took an average of 79.20 minutes in a 2025 study of 50 children with acute uncomplicated appendicitis.
The Quick Take
- What they studied: Whether a new camera-tube procedure could safely treat appendicitis in children without removing the appendix
- Who participated: 50 children (47 successfully treated) with acute uncomplicated appendicitis admitted to a children’s hospital in China between November 2024 and April 2025
- Key finding: 94% of children were successfully treated with the tube procedure, stayed in the hospital for about 4 days, but 12% developed appendicitis again within 7.8 months and needed traditional surgery
- What it means for you: This technique might offer kids with appendicitis a less invasive treatment option that avoids removing the appendix, though the risk of the problem returning is something families should discuss with their doctors
The Research Details
Researchers looked back at medical records from 50 children who had appendicitis and were treated at a hospital in Shenzhen, China. All the children received the same new treatment: a special camera tube procedure called cholangioscope-assisted endoscopic retrograde appendicitis therapy (ERAT). This technique uses a thin tube with a camera to look inside the appendix and treat the infection without making large cuts or removing the appendix.
The doctors carefully tracked what happened to each child, including how long the surgery took (about 79 minutes on average), how long they stayed in the hospital (about 4 days), and whether they had any problems after going home. They followed up with the children for an average of 7.8 months to see if the appendicitis came back.
The researchers compared children who had the problem return with those who didn’t, looking for differences in how quickly they could eat after surgery and what the camera showed about the appendix opening.
This research approach is important because it tests whether a newer, less invasive technique could replace traditional appendix removal surgery in children. By carefully tracking outcomes and comparing successful cases with those that had problems, doctors can understand which children might benefit most from this approach and which warning signs suggest the problem might return.
This study is a retrospective review, meaning doctors looked back at records rather than following children forward in time. The sample size is relatively small (50 children), which limits how much we can generalize the findings. The study was conducted at a single hospital in China, so results may differ in other places. The follow-up period of 7.8 months is moderate—longer follow-up would give more confidence about recurrence rates. The study provides specific measurements with confidence intervals, which shows careful data analysis.
What the Results Show
Among the 50 children treated with the tube procedure, 47 (94%) were successfully treated without needing to remove the appendix. The average surgery took about 79 minutes, and children stayed in the hospital for approximately 4 days before going home.
During the follow-up period averaging 7.8 months, 6 children (12% of the successfully treated group) developed appendicitis again. These children then underwent traditional surgery to remove the appendix. This means that while the tube procedure worked initially for most children, some experienced a return of the problem.
The researchers found important differences between children whose appendicitis returned and those who stayed healthy. Children who developed appendicitis again had more difficulty tolerating liquid food in the first 12 hours after the procedure and showed narrowing of the appendix opening when viewed through the camera. These two factors may help doctors predict which children are at higher risk for recurrence.
The study found that the procedure was generally well-tolerated, with children able to go home within 4 days on average. The specific camera findings (narrowing of the appendix opening) appeared to be an important warning sign that doctors should watch for. Early feeding tolerance after the procedure also seemed to matter—children who couldn’t eat liquids well in the first 12 hours were more likely to have problems later.
This research builds on growing interest in less invasive treatments for appendicitis. Traditional appendectomy (surgical removal) has been the standard treatment for decades, but recent studies have explored whether some cases can be managed without surgery. This study’s 94% initial success rate is encouraging compared to some previous approaches, though the 12% recurrence rate suggests the technique isn’t perfect for all children. More research is needed to compare this method directly with traditional surgery and other minimally invasive approaches.
The study has several important limitations. First, it’s relatively small with only 50 children, so results might not apply to all children everywhere. Second, it was conducted at just one hospital in China, so outcomes might differ in other countries or settings. Third, the follow-up period of 7.8 months is moderate—longer follow-up would show whether more children develop recurrent appendicitis later. Fourth, this was a retrospective study looking back at records rather than a controlled trial comparing this method to other treatments. Finally, the study doesn’t explain why some children had recurrence while others didn’t, making it hard to predict which children would benefit most.
The Bottom Line
Cholangioscope-assisted endoscopic retrograde appendicitis therapy appears to be a safe option for treating uncomplicated appendicitis in children, with a 94% initial success rate. However, because 12% of children developed recurrent appendicitis within 7.8 months, this technique should be considered carefully and only for appropriate cases. Families should discuss with their doctors whether this approach or traditional appendix removal is best for their child. Close follow-up is essential to catch any recurrence early.
This research is most relevant for children diagnosed with acute uncomplicated appendicitis and their families who want to explore less invasive treatment options. Pediatric surgeons and emergency medicine doctors should be aware of this technique as a potential alternative to traditional surgery. Parents should understand that while this approach avoids appendix removal, there’s a meaningful risk of the problem returning. This technique may not be appropriate for all types of appendicitis, particularly complicated cases.
Children treated with this procedure typically go home within 4 days. Most children who will have successful outcomes show this within the first 12 hours after surgery (based on their ability to eat and camera findings). However, appendicitis can return months later—in this study, recurrence was detected within the 7.8-month follow-up period. Families should expect regular check-ups and be alert for symptoms of appendicitis returning.
Frequently Asked Questions
Can appendicitis be treated without surgery in children?
A 2025 study shows that a camera-tube procedure successfully treated 94% of children with appendicitis without removing the appendix. However, 12% developed appendicitis again within 7.8 months, so this approach works initially for most but carries recurrence risk.
What is cholangioscope-assisted endoscopic retrograde appendicitis therapy?
It’s a minimally invasive procedure using a thin tube with a camera to treat appendicitis from inside without making large surgical cuts or removing the appendix. The 2025 study found children went home after about 4 days using this technique.
How long do kids stay in the hospital after this appendicitis procedure?
According to a 2025 study of 50 children, the average hospital stay was 3.96 days. Most children could go home within 4 days and resume normal activities relatively quickly compared to traditional appendix removal surgery.
What signs suggest appendicitis might come back after the tube procedure?
A 2025 study found that children who couldn’t eat liquids well in the first 12 hours after the procedure and those with narrowing of the appendix opening were more likely to develop recurrent appendicitis requiring surgery later.
Is this new appendicitis treatment better than traditional surgery?
The 2025 study shows the tube procedure avoids appendix removal and gets kids home faster, but 12% develop appendicitis again within 7.8 months. More research directly comparing this method to traditional surgery is needed to determine which is better for different children.
Want to Apply This Research?
- Track daily symptoms including abdominal pain location and intensity (1-10 scale), appetite level, and any fever or nausea. Log these daily for the first 2 weeks post-procedure, then weekly for 3 months, then monthly for at least 6 months.
- Set reminders for follow-up appointments with your surgeon. Create a symptom log in the app to quickly report any concerning signs (sharp abdominal pain, fever, vomiting) to your healthcare provider. Document what you eat and how you feel after meals during the recovery period.
- Use the app to track a ‘health score’ combining pain level, appetite, and fever presence. Alert users to contact their doctor if pain returns or worsens, if fever develops, or if vomiting occurs. Generate monthly reports comparing current symptoms to baseline to help identify early signs of recurrence.
This article summarizes research on a surgical technique for treating appendicitis in children. It is not medical advice. Appendicitis is a serious condition requiring immediate medical evaluation. Parents and caregivers should consult with qualified pediatric surgeons and emergency medicine doctors to discuss treatment options appropriate for their child’s specific situation. The choice between minimally invasive procedures and traditional surgery should be made in consultation with healthcare providers who can evaluate the individual child’s condition, age, and medical history. This research represents findings from a single-center study and may not apply to all children or healthcare settings.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.