Feasibility and Safety of a Pediatric ERAS Protocol for Laparoscopic Appendectomy

Inclusion Criteria: 1. Pediatric patients aged 5 to 18 years (preschool, school-age, and adolescent). 2. Acute appendicitis without preoperative radiologic or clinical evidence of complication/perforation, who are candidates for and accept laparoscopic surgery. 3. ASA Physical Status I (healthy) or ASA II (mild systemic disease). 4. Family/legal guardians literate in Turkish (or the institution's primary service language) and able to comprehend the educational materials. 5. Written informed consent from parents/legal guardians; for children of sufficient developmental maturity (generally ≥7 years), age-appropriate written assent. Exclusion Criteria: 1. Preoperative imaging or clinical evidence of complicated appendicitis (perforation, generalized peritonitis, intra-abdominal abscess) anticipated to require an extended procedure (anastomosis, resection, or extensive peritoneal irrigation). 2. History of chronic pain syndrome or regular/sustained opioid use within the past 3 months. 3. Therapeutic preoperative antibiotic treatment for an active infection (other than surgical prophylaxis). 4. ASA III or higher; immunosuppression, progressive neurological disease, chronic inflammatory bowel disease, or other significant comorbidities likely to interfere with postoperative recovery/mobilization. 5. Anatomic/mechanical contraindications to laparoscopy or pneumoperitoneum (e.g., prior major open abdominal surgery with suspected adhesions, abdominal wall defects).