Laparoscopic single trocar appendectomy

Abstract

Background and objective: Single port surgery is a new surgical technique with more promising advantages of minimal access laparoscopy. The present study was to assess the feasibility of the single trocar appendectomy, its morbidities and satisfaction for both patients and surgeons. Methods: Consecutive patients presenting with acute appendicitis were treated by single port appendectomy. Through an umbilical incision, the single port was inserted, we used SJLS port (Covidien) in 15 cases and Xcone port (Karl Storz) in 27 cases. A 5mm 30° lens was used. The mesoappendix was coagulated and divided by Ligasure, Harmonic scalpel or diathermy. Absorbable endoloops were used to ligate the base of the appendix. Assessment included operative time, complications, patient satisfaction and surgeon satisfaction. Results: The study included 42 patients, 24 (57.1%) females and 18 (42.9%) males with a mean age of27.3±5.4 years. The procedure was completed in all of the patients. Complications occurred in 4 patients (9.5%). The mean hospital stay was 1.1 days± I. The procedure achieved accepted cosmetic outcome with minimal or hidden scar. The patients were satisfied as good or very good procedure. The surgeons found it satisfactory in 67.6% of operations as regards technical difficulties and outcome. Conclusion: The procedure is feasible and safe. Neither mortality nor visceral injury occurred in this study. Rate of complications was 9.5%. Accepted rate of satisfaction was present for both patients and surgeons. It achieved accepted cosmetic results with minimal or hidden scar. Complications are expected to decrease by improvement in the learning curve.