Single-Port Transumbilical Laparoscopic Appendectomy: A Preliminary Multicentric Comparative Study in 87 Patients with Acute Appendicitis

Ramon Vilallonga,José Manuel Fort,Aziz Sümer,Manuel Armengol,Umut Barbaros,Tuğrul Demirel,Ahmed Nada,Oscar González

doi:10.1155/2012/492409

Abstract

Introduction. Laparoscopic appendectomy (LA) has been performed in many approaches such as open, laparoscopic and recently Single Port Access (SPAA). In order to elucidate its potential advantages, we compared the two laparoscopic approaches. Methods. 87 patients were included in a multicentric study for suspected appendicitis in order to perform (SPAA) appendectomy or laparoscopic appendectomy (LA). All outcomes, including blood loss, operative time, complications, and length of stay and pain were recorded prospectively. Results. There were 46 patients in the SPAA group and 41 in the LAG with a mean operative time of 40,4 minutes in the SPAA group and 35,0 minutes in the LA group. Only one patient was converted to an open approach. We described only 2 complications. Pain was graded 2,8 in the SPAA group and 2,9 in the LA group, according to the AVS after 24 hours. Patients in the SPAA Group were more satisfied (7,5 versus 6,9) (P < 0.05). Same results were found for the cosmetic result (8,6 versus 7,4) (P < 0.05). Conclusion. Using the single port approach feasible and safe. The true benefit of the technique should be assessed by new randomised controlled trials.

Highlights

Laparoscopic appendectomy (LA) has been performed in many approaches such as open, laparoscopic and recently Single Port Access (SPAA)
A new era has been opened with recent innovations that have pioneered the use of single-incision laparoscopic surgery (SILS) or Single Port Access (SPA)
Between July 2009 and March 2010, 87 patients were randomized for suspected appendicitis into the SPA appendectomy (SPAA) group (SPAAG) or an laparoscopic appendectomy (LA) group (LAG)

Summary

Introduction

Laparoscopic appendectomy (LA) has been performed in many approaches such as open, laparoscopic and recently Single Port Access (SPAA). A new era has been opened with recent innovations that have pioneered the use of single-incision laparoscopic surgery (SILS) or Single Port Access (SPA). This novel technique or approach may be placed between the pure NOTES surgery, the hybrid NOTES surgery, and the standard laparoscopic surgery [2,3,4,5]. First report of single-puncture laparoscopic appendectomy technique was performed in 1992 and showed the new approach as a safe, inexpensive, and effective alternative to the currently used multiple-puncture method [7]

Objectives

Methods

Results

Discussion

Conclusion