Abstract
Single port appendectomy, due to its cosmetic appeal and to a technique similar to classic laparoscopic appendectomy, is provoking an increasing number of publications and case series to explore its feasibility and effective improvements for patients with acute appendicitis. The margins for improvement are not so large, as laparoscopic appendectomy is, after 20 years from its beginning, still debated. A literature search has been accomplished to investigate the outcomes of the operation. 23 case series or retrospective comparisons with classic laparoscopy have been found. The numbers and low quality of the published data do not permit to draw evidence based conclusions. Still, trends seem to evidence an increase in complications especially in complicated appendicitis, which suggests caution in its dissemination outside clinical trials.
Highlights
As soon as surgical access-natural orifice surgery (SANOS) has been clearly distinguished from endoscopical access-natural orifice surgery (EA-NOS), being the former more similar to classic laparoscopy and more surgeon-friendly, the trend toward miniinvasiveness has caused a wide dissemination of single port-transumbilical surgical operations [1]
If we sum the overall complications of the published Single port appendectomy (SPA) cases we find a 4.8% rate of surgical complications, which is higher than that reported in the literature for laparoscopic appendectomy (LA)
The use of dedicated instruments might rise the cost of single port appendectomy; this problem has been overcome with difficulty in the era of LA, and SPA might induce the surgeon, once again, to increase the utilization of high-tech instruments to enhance safety and to lower operative time [16]
Summary
As soon as surgical access-natural orifice surgery (SANOS) has been clearly distinguished from endoscopical access-natural orifice surgery (EA-NOS), being the former more similar to classic laparoscopy and more surgeon-friendly, the trend toward miniinvasiveness has caused a wide dissemination of single port-transumbilical surgical operations [1]. Single port appendectomy (SPA) is gaining quite an interest in the surgical community. From single access cholecystectomy the operation is feasible and potentially safe, as the procedure can be carried out approximately in the same manner as the three-port laparoscopic appendectomy (LA)[2]. Need to be pointed out, because the advantages for classical laparoscopic appendectomy are not quite ascertained as they are for laparoscopic cholecystectomy. Search method and results A literature search has been made in PubMed and Google Scholar using key words “single port - single access single incision AND appendectomy - appendicectomy -
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