Single-Port Laparoscopic Appendicectomy

Abstract

TECHNIQUE The patient should be prepared as for a standard manipulation and insertion of K-wires. Closed manipulation should attempted. If this is not successful in restoring anatomy, the additional Kwire may be inserted as described below. A 2-cm incision should be made over the medial epicondyle with the elbow extended and deepened to the bone with meticulous attention to preservation of the ulna nerve. A 2-mm (1.6 mm in young children) K-wire should then be inserted from medial to lateral (under X-ray control) passing through the trochlea and through the capitellum. It should then be passed out through the skin to provide a bar: this can be used to provide both traction and torque to the distal fragment allowing reduction to be easily achieved. Once satisfactory reduction is accomplished, traditional crossed K-wires should be passed using the 2-cm wound used for the medial K-wire. The transverse K-wire is now removed leaving the fracture held by the two standard K-wires.