Adoption of laparoscopic appendectomy in pediatrics: analysis of data from the integrated social protection information system (SISPRO), Colombia (2015–2022)

Background: Laparoscopic appendectomy is the recommended treatment for acute appendicitis in pediatric patients. However, its adoption in middle-income countries like Colombia is poorly documented. Methods: We conducted a retrospective, descriptive study using Colombia's SISPRO database to identify patients under 15 years who underwent appendectomy between 2015 and 2022. We analyzed the frequency of laparoscopic versus open appendectomy by year, sex, geographic region, hospital type (public or private), health insurance regime, and average cost in 2022. Results: A total of 67,373 appendectomies were reported; 23.6% (n = 15,910) were laparoscopic. The proportion of laparoscopic procedures increased from 13.1% in 2015 to 25.4% in 2022. There were no significant differences between sexes. Adoption varied widely by region, with higher rates in Cali (60.5%) and Bogotá D.C. (58.1%) compared to Antioquia (15.5%). Laparoscopic surgery was more common in private hospitals and among patients in the contributory and private insurance regimes (up to 83.5%), and least frequent among those in the subsidized regime (11.0%). In 2022, the average cost was 1698,864 COP (USD 384) for laparoscopic and 1075,185 COP (USD 243) for open appendectomy. Conclusions: Despite clinical guidelines recommending laparoscopic appendectomy in children, its adoption in Colombia remains limited and uneven. Socioeconomic factors, institutional infrastructure, and insurance type may influence this disparity. Understanding these barriers is essential for promoting equitable surgical care and broader implementation of minimally invasive techniques in pediatric populations across the country.