Port Laparoscopic Appendectomy Research Articles

Towards Sustainable Surgery: Evaluating the Environmental and Economic Benefits of Transumbilical Laparoscopic Appendectomy vs 3-Port Laparoscopic Appendectomy.

Towards Sustainable Surgery: Evaluating the Environmental and Economic Benefits of Transumbilical Laparoscopic Appendectomy vs 3-Port Laparoscopic Appendectomy.

Comparison of Climate Impact, Clinical Outcome, and Cost-Efficiency of Pediatric Transumbilical Laparoscopic Assisted Appendectomy vs Standard 3-Port Laparoscopic Appendectomy.

Healthcare is responsible for 8.5% of US greenhouse gas emissions. These impacts must be mitigated while maintaining clinical excellence. This study compares clinical outcomes, cost-efficiency, and climate impact of trans-umbilical laparoscopic assisted appendectomy (TULAA) versus 3-port laparoscopic appendectomy (LA). Institutional Review Board approval was obtained. Appendectomies performed between Jan 1, 2020 and December 31, 2022 at a tertiary children's hospital were reviewed. Data abstracted included clinical characteristics, operative approach and findings, supplies and equipment utilized, and complications. For analysis TULAA was combined with cases converted to LA (TULAA+C). To determine a surgical site infection (SSI) increase of ≤ 2.5%, a minimum sample size of 479 patients per group was needed to achieve a power of 80%. A composite supply list for each approach was determined by averaging supplies from cases reviewed. The composite was used to calculate cost-efficiency and climate impact. Life cycle assessment was used to determine the carbon footprint (according to ISO 14067) of supplies and equipment. Analysis was performed on 1,611 appendectomies: 497 LA and 1,114 TULAA+C (932 TULAA, 182 converted). Except for BMI, there were no clinically significant differences between groups. SSI did not increase with TULAA+C (n=15, 1.3%) versus LA (n=6, 1.2%), p=0.81. TULAA+C ($369.21/case) was more cost efficient than LA ($879.30/case) and TULAA+C (24.8 kg CO2e) produced fewer emissions than LA (27.4 kg CO2e). While patient safety and excellent clinical outcomes must remain the top priority in healthcare, the current environmental crisis demands consideration of climate impacts. When clinical non-inferiority can be demonstrated, treatment options with a fewer greenhouse gas emissions should be chosen.

Comparative Study of Single Incision Laparoscopic Appendectomy (SILA) using Conventional Instruments versus Conventional Laparoscopic Appendectomy

Background: Laparoscopic surgery has become the procedure of choice for treating appendicitis. But in this evolving era, single incision laparoscopic surgery for appendicitis is gaining importance because of its cosmetic benefits. So, here we compared outcomes of two laparoscopic surgeries in terms of intraoperative time, postoperative pain, postoperative hospital stay, postoperative tolerance to diet, postoperative complications & cosmesis. Method: A total of 100 patients who underwent laparoscopic appendectomy were studied. Patients were grouped under 2 categories randomly, group A undergoing single incision laparoscopic appendectomy (SILA) & group B undergoing conventional three port laparoscopic appendectomy (CLA). Post operatively, duration of surgery, post-operative time, post-operative hospital stay, tolerance to diet, patients satisfaction were monitored. Result: Our study included 100 patients- 50 in group A(SILA) & 50 in group B(CLA). Duration of surgery was significantly longer in group A as compared to group B(42.77 min vs 35.47 min ; p<0.001). Patients had significantly lower pain score at 24 hours postoperatively in group A as compared to group B(3.38 vs 4.62, p<0.001). Post-surgical complications in terms of superficial surgical site infection were more in group A(4 vs 2, p ). There was no significant difference in postoperative hospital stay and tolerance to oral feed postoperatively. There was no conversion to open appendectomy in both the groups. There was significant higher patients satisfaction score in group A patients (8.40 vs 6.12, p<0.001). Conclusion: In addition to better cosmesis after SILA, SILA inflicts considerable less pain postoperatively than CLA with no significant differences in postoperative tolerance to oral diet, surgical site complications & hospital stay.

Laparoscopic Appendicectomy Using "Mian Waleed's (MW) Ultragrasper

Introduction: The two Port Laparoscopic Appendectomy (TPLA) methods sits between the single port laparoscopic surgery and traditional three port trocar. Though TPLA, the appendix is held with sutures, which creates a risk of perforation and trouble in exploration. Objective: The paper represents our experience with the usage of needle grasper in two Ports Laparoscopic Appendectomy to manipulate and suspend the appendix. Methods: 36 (11 women, 25 men) who endured TPLA were retrospectively analyzed in terms of duration of surgery, patient demographics, conventional laparoscopy or the need for laparotomy, complications, drain use and extent of hospital stay. The MW ultragrasper was placed just below the quadrant of abdomen at McBurney's point without giving incision to manipulate and hang the appendix. Results: 26.80 ± 7.61 years was the mean age with 22.68 ± 3.88 kg / m2 mean body mass index (BMI). The ASA score was 1 and 2. In 34 patients, the operation was accomplished deprived of an extra trocar. 58.11 ± 3.29 mints were the mean operative time. No patient has any intraoperative complications. Drains were obligatory in three patients; They were all discharged after removing the drain. 31 subjects were discharged on the first day after surgery; 3 patients were discharged with drains on 2nd day. 1.42 ± 0.49 days were the mean stay in hospital. Conclusion: By means of a MW ultra grasper, the appendix was suspended and held, and the meso-appendix was successfully skeletonized and cauterized in two Ports Laparoscopic Appendectomy. To manipulate the appendix, it is helpful to insert the MW ultra grasper into the cavity of abdomen at the McBurneys point and leave no visible scarring. Keywords: Minimally invasive surgery, MW ultra grasper and laparoscopic appendectomy.

Single-Incision Versus Conventional Laparoscopic Appendectomy: A Multi-Center Randomized Controlled Trial (SCAR trial).

Introduction:Although single-incision laparoscopic appendectomy (SILA) was introduced decades ago, it is still considered a difficult technique to perform compared to conventional laparoscopic appendectomy (CLA). In addition, controversy about the benefits of SILA compared to CLA abound and no definite criteria for choosing SILA over CLA in patients with appendicitis currently exist. Therefore, we have planned a multi-center randomized controlled trial to compare SILA with CLA in terms of cosmetic satisfaction and pain reduction.Methods and analysis:Patients diagnosed with appendicitis at the participating centers will be recruited and allocated into either a CLA or an SILA groups using a 1:1 randomization. Patients in the CLA group will receive a conventional 3-port laparoscopic appendectomy and patients in the SILA group will receive a laparoscopic appendectomy using a single-incision at the umbilicus. The primary trial endpoint is cosmetic satisfaction assessed using the Patients and Observer Scar Assessment Scale (POSAS) administered 6 weeks post-surgery. Secondary trial endpoints include cosmetic satisfaction assessed via the Body Image Questionnaire, pain levels assessed via the Visual Analog Scale and International Pain Outcomes questionnaire, and the presence of postoperative complications. The target sample size of this superiority trial is 120 patients, as this will provide 80% power at the 2.5% level of significance to detect a 3-point difference in POSAS.Discussion:The results of this planned multi-center randomized controlled trial will provide substantive evidence to help surgeons choose when to use SILA over CLA in patients with appendicitis.Ethics and dissemination:This trial was approved by the institutional review board at Daegu joint on February 27, 2020 (No: 19-12-001-001) and registered with the clinical research information service (CRIS) (KCT0005048). The results of the study will be published and presented at appropriate conferences.HighlightsTo investigate the clinical benefits comparing between single incision laparoscopic appendectomy and conventional laparoscopic appendectomyTo assess the pain and cosmetic satisfaction through quantitative scales, Patient-Reported Outcomes Measures (PROMs), International Pain Outcome (IPO) Questionnaire, the Patient and Observer Scar Assessment Scale (POSAS), and the Body Image Questionnaire (BIQ)To help surgeons choose when to use single incision laparoscopic appendectomy in patients with appendicitis.

Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis

The objective of this study was to compare the perioperative outcomes between single-incision laparoscopic appendectomy (SILA) and 3-port conventional laparoscopic appendectomy (CLA) in enhanced recovery after surgery (ERAS) protocol. Of 101 laparoscopic appendectomy with ERAS protocol cases for appendicitis from March 2019 to April 2020, 54 patients underwent SILA with multimodal analgesic approach (group 1) while 47 patients received CLA with multimodal analgesic approach (group 2). SILA and CLA were compared with the single institution's ERAS protocol. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM). After 1:1 PSM, well-matched 35 patients in each group were evaluated. Postoperative hospital stays for patients in group 1 (1.2 ± 0.8 vs. 1.6 ± 0.8 days, P = 0.037) were significantly lesser than those for patients in group 2. However, opioid consumption (2.0 mg vs. 1.4 mg, P=0.1) and the postoperative scores of visual analogue scale for pain at 6 hours (2.4±1.9 vs. 2.8 ± 1.4, P = 0.260) and 12 hours (2.4 ± 2.0 vs. 2.9 ± 1.5, P = 0.257) did not show significant difference between the 2 groups. SILA resulted in shortening the length of hospitalization without increase in complications or readmission rates compared to CLA with ERAS protocol.

Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis.

PurposeThe objective of this study was to compare the perioperative outcomes between single-incision laparoscopic appendectomy (SILA) and 3-port conventional laparoscopic appendectomy (CLA) in enhanced recovery after surgery (ERAS) protocol.MethodsOf 101 laparoscopic appendectomy with ERAS protocol cases for appendicitis from March 2019 to April 2020, 54 patients underwent SILA with multimodal analgesic approach (group 1) while 47 patients received CLA with multimodal analgesic approach (group 2). SILA and CLA were compared with the single institution’s ERAS protocol. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM).ResultsAfter 1:1 PSM, well-matched 35 patients in each group were evaluated. Postoperative hospital stays for patients in group 1 (1.2 ± 0.8 vs. 1.6 ± 0.8 days, P = 0.037) were significantly lesser than those for patients in group 2. However, opioid consumption (2.0 mg vs. 1.4 mg, P=0.1) and the postoperative scores of visual analogue scale for pain at 6 hours (2.4±1.9 vs. 2.8 ± 1.4, P = 0.260) and 12 hours (2.4 ± 2.0 vs. 2.9 ± 1.5, P = 0.257) did not show significant difference between the 2 groups.ConclusionSILA resulted in shortening the length of hospitalization without increase in complications or readmission rates compared to CLA with ERAS protocol.

A study of single sight two port laparoscopic appendectomy for its feasibility, advantages and disadvantages

Minimally invasive techniques revolutionized surgery with severe reduction of access trauma, prompt mobilization, lessened hospital stays and better cosmesis.1 Laparoscopic appendectomy can be further categorized into three port and reduced port appendectomy. All the selected cases have been put in a tabulated form on the basis of their age, clinical features and signs, ultrasonography findings, intra op complications, duration of surgery, duration of post op pain, early post op complications, cosmetic outcome and trochar size. 20 patients fulfilling inclusion and exclusion criteria, who were admitted in our hospital (SMIMER Surat) from 1st December, 2019 to 1st April 2020 and were included in the study and underwent single sight two port laparoscopic appendectomy (SSTPLA) after their consent. We have covered the entire procedure of single sight two port appendectomy, its technique, feasibility, advantages, and disadvantages. From our study, we conclude that this new technique of SSTPLA is technically safe and feasible. Our experience of this innovative surgical technique is suggestive of the fact that SSTPLA has better patient satisfaction with respect to cosmesis, decreased post-operative pain, decreased hospital stay, decreased operative time, fewer intra operative and post-operative complications and surgeon satisfaction with respect to ergonomics and decreased chances of collision of laparoscope with only single working instrument.

Modified glove single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy in adolescent age under spinal anesthesia

The glove single-port laparoscopic appendectomy is a novel single incision laparoscopic technique (SILT) which is extremely cheaper than the other commercial devices. This study aimed to compare conventional laparoscopic appendectomy (CLA) and glove single port laparoscopic appendectomy (GSPLAP) in adolescents performed under spinal anaesthesia (SA). Forty-eight adolescents with uncomplicated appendicitis were included in the current study. All patients were randomized into 2 groups. Group A was operated upon by GSPLAP and group B, was operated upon using CLA. All cases were done under SA. Forty-eight adolescents were treated either by GSPLAP or LAP during the period from September 2017 to August 2018. They were 30 males and 18 females with a mean age 14.8 ± 2.2 years (range = 12–18 years). All procedures were completed laparoscopically without conversion. Only 2 cases of group A were converted to CLA. The mean operative time was 35.14 ± 12.14 min (range = 26–80 min) for CLA and 50.3 ± 11.2 min (range = 40–88 min) for GSPLAP. SA was successful in 44 cases [91.7%], while 4 patients [8.3%] were converted to general anaesthesia [GA]. Post SA headache was reported in 3 cases. Post-operative umbilical cellulitis occurred in two cases. Our modification of Glove Single Port is technically feasible. The GSPLAP is a new SILT which is cheaper than other single incision laparoscopic devices in the market. This study proved that SA for laparoscopic appendectomy (LAp) is a good substitute of GA in adolescents.

Preliminary Experience of Glove Single Port Laparoscopic Appendectomy in Children and Adolescents for Uncomplicated Appendicitis

Preliminary Experience of Glove Single Port Laparoscopic Appendectomy in Children and Adolescents for Uncomplicated Appendicitis

Disposable free three port laparoscopic appendectomy – low cost alternative for emergency

Disposable free three port laparoscopic appendectomy – low cost alternative for emergency

Development of a Two Port Laparoscopic Appendectomy Technique at a Rural Hospital.

Background Laparoscopic appendectomy (LA) is most commonly performed using two 5-mm and one 10/12-mm ports. Various attempts to reduce the number and size of ports have been made and new technologies such as single port LA have been introduced. Appendix and mesoappendix are usually divided with a stapler or energy device with electrocautery, clips, and endoloop being cheaper options. Patients and Methods This study includes 51 consecutive LAs performed at a rural hospital. Patients were divided into 4 groups: group 1 was the standard technique group (n=12), group 2 served as a “try-out” (n=12), group 3 served as feasibility group (n=12), and group 4 was the final patient cohort in which the optimized technique was preferably used (n=15). Results Median age of the study cohort was 35.4 (range: 6.2-80.6) years, and 55% of patients were male. Whereas in G1 all patients had standard port placement (10/12-mm, 2x5-mm), in an increasing number of patients in G2-4 only two 5-mm ports and the 2.3-mm Teleflex minigrasper were inserted. Usage of staplers and/or energy devices was reduced from 100% in G1 to 20% in G4, and in the majority of cases both the appendix and the vascular pedicle were secured with an endoloop. The new technique did not add time to the procedure or total OR time. No stump-leaks or surgical site infections were encountered in this series, and there were no conversions to open surgery. Cost savings when not using a stapler or energy device are approximately 400$ per case; the minigrasper added approximately 200$ to the case. Discussion LA with use of two ports and a portless needle grasper is feasible in the majority of cases and was associated with high patient satisfaction and excellent cosmetic results. Avoiding energy devices and staplers is cost saving; the endoloop securely controls appendix and mesoappendix.

LAPAROSCOPIC APPENDECTOMY;

Background: Minimal invasive surgery (MIS) is a modern and safe improvement in field of laparoscopic surgery. Single incision laparoscopic appendectomy (SILA) is a major breakthrough in MIS and has become standard procedure for acute appendicitis in place of conventional three port laparoscopic appendectomy (CTLA). Objectives: To see the potential advantages in terms of operative time, duration of hospital stay, post-operative pain and cosmetic results in SILA and CTLA groups. Study Design: Randomized control study. Setting: Department of General Surgery in Allama Iqbal Medical College/ Jinnah Hospital Lahore. Period: July 2016 to June 2017. Materials and Methods: 48 patients were divided in two groups; group SILA (cases) and CTLA (control). Each group comprised 24 patients. All cases were performed by consultant who were competent enough and trained in MIS. Results: We found that there was statistically no difference in operative time (p>0.05) and post-operative pain (p>0.05) of both procedures but statistically significant outcome was observed in duration of hospital stay (p<0.005) and cosmetic result (p< 0.005). Post-operative analgesia usage was same in both groups with similar outcome of control. Surgical wound healed in all patients of both groups without complication but noticeably had shown no scar mark on three months follow up in patients of SILA group. Almost all patients in SILA group were discharged on same day on oral diet. Conclusion: This study showed that results of SILA are better in terms of cosmoses and less duration of hospital stay in the presence of non-significant operative time of two procedures. Staying with promise of minimizing in MIS to SILA, cosmetic satisfaction and minimal hospital stay are its comprehensible advantages.

Laparoscopic Appendectomy versus Glove Single Port Laparoscopic Appendectomy in Pediatrics under Spinal versus General Anesthesia. A controlled Randomized Study

Background: The glove single-port laparoscopic appendectomy it is a novel SILS technique which is extremely cheaper than the other commercial devices. Objective: this study aimed to compare between conventional laparoscopic appendectomy (CLAP) and glove single port laparoscopic appendectomy (GSPLAP) under tow different anesthetic technique. Patients and Methods: this study of laparoscopic appendectomy was conducted over thirty six children (n=36). All patients were randomized into 4 groups by a random-number table sequence after giving informed parental consent. The allocations will be contained in opaque sequentially numbered closed envelopes and every patient drew an envelope. Results: Two cases of GSPLAP were converted to multi-port due to difficult accessibility of the appendix and adhesions (suppurative appendicitis). The Mean operative time for CLAP was significantly lower than GSPLAP procedure. For CLAP was 38.39±10.12 min (ranged from 26 to 75 min) and was 49.11±11.98 min (ranged from 38 to 86 min) for GSPLAP. We observed that GSPLA was less painful significantly than CLAP for the first postoperative hours (≤3hrs) the time of postoperative needs of analgesia in pt. underwent LA under SA is delayed. Conclusion: Using a combination of 0.5% hyperbaric bupivacaine and a fentanyl provided effective anesthesia for laparoscopic appendectomy with low-pressure Co2 Pneumoperitoneum. It offers better pain management for the patients, earlier recovery and less operating room costs. We recommend an increasing use of spinal anesthesia for laparoscopic appendectomy especially in patients with risks for general anesthesia.

Comparative study of single incision versus conventional three port laparoscopic appendectomy

Background: Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decades of life. Appendectomy for appendicitis is the most commonly performed emergency operation in the world.For more than a century, open appendectomy remained the gold standard for the treatment of acute appendicitis. Laparoscopic surgery has become popular universally during the last couple of decades. Efforts are still being made to decrease abdominal incision and visible scars after laparoscopy. Single incision laparoscopic surgery (SILS) is a new innovation allowing minimal access surgery to be performed through a single umbilical incision.Methods: It was a prospective study carried out on 50 patients diagnosed as acute appendicitis. They were divided into two groups of 25 each. One group underwent Conventional Laparoscopic Appendectomy (CLA) and other group underwent Single Incision Laparoscopic Surgery (SILS). Results were compared with regard to mean operative time, complications, post-operative pain and discomfort (vas score at 12 hours), post-operative morbidity, duration of hospital stay and condition at discharge and cosmesis.Results: There was no statistically significant difference between the two groups with respect to the parameters like postoperative pain, hospital stay and complication profile. However, operative time for SILS appendectomy were found to be significantly higher compared to conventional group.Conclusions: Single incision laparoscopic appendectomy using standard laparoscopic instruments is safe and effective, feasible surgery with better cosmetic results.

TWO-PORT LAPAROSCOPIC APPENDECTOMY IS MORE BENEFECIAL THAN OPEN APPENDECTOMY IN EARLY ACUTE APPENDICITIS

Open appendectomy has already commonly been performed to treat acute appendicitis, but the relatively more painful and longer incision scar becomes a cosmetical problem. Two port laparoscopic appendectomy can be performed safely, less painful and leaving only two small incision scars. The aim of the study was to evaluate the benefit of two-port laparoscopic appendectomy and that of with open appendectomy in the case of early acute appendicitis. An observational study was conducted from 2012 to 2014; to compare the operating time, post operative pain and wound infection in early acute appendicitis, performed with two-port laparoscopic appendectomy and with open appendectomy. The statistical analysis in this study uses t-test. There were 114 patients (73 men and 41 women) divided into two groups based on the choice made by the patients themselves. The number of samples performed with two-port laparoscopic appendectomy was 64 and that with open appendectomy was 46. Four patients were excluded from this study. In analysis using t-test, we found that the two-port laparoscopic appendectomy was more beneficial than open appendectomy. There was a significant difference between the two groups, the length of operation time was 37.22 minute in two-port laparoscopic appendectomy and 43.83 minute in open appendectomy (p=0.00), VAS pain score was 1.58 in two-port laparoscopic appendectomy and 2.30 in open appendectomy (p=0.00) and no post operative wound infection in both two groups. The conclusion is two-port laparoscopic appendectomy technique is faster and less painful and the same risk of wound infection than open appendectomy in early acute appendicitis.

Apendicectomía laparoscópica por sistema «glove port»: nuestros primeros 100 casos

IntroductionSingle port laparoscopic appendectomy is an advance in minimally invasive techniques. The objective of this study is to show our series of 100 cases of acute appendicitis, operated through a single port technique using the ‘glove port’ system, exposing our technique, results and follow up of our patients. Material and methodsWe present the series of 100 cases intervened from February 2013 to January 2017 detailing the elements that make up the ‘glove port’ system. ResultsOf the 100 operated appendicitis, there were 3 postoperative collections and 1 surgical wound infection, which shows the good results obtained with this technique, emphasizing the excellent aesthetic result. We also point out that it is an economic system that does not make conventional laparoscopy more expensive. ConclusionsSingle port laparoscopic appendectomy is safe, effective, economical and useful for the surgeon to acquire skills in a single port laparoscopic approach.

Ultrasound-guided bilateral rectus sheath block vs. conventional local analgesia in single port laparoscopic appendectomy for children with nonperforated appendicitis

IntroductionDespite its minimally invasive approach, laparoscopic surgery can cause considerable pain. Regional analgesic techniques such as the rectus sheath block (RSB) offer improved pain management following elective umbilical hernia repair in the pediatric population. This effect has not been examined in laparoscopic single-incision surgery in children. We sought to compare the efficacy of bilateral ultrasound-guided RSB versus local anesthetic infiltration (LAI) in providing postoperative pain relief in pediatric single-incision transumbilical laparoscopic assisted appendectomy (TULA) with same-day discharge. MethodsWe retrospectively reviewed 275 children, ages 4 to 17 years old, who underwent TULA for uncomplicated appendicitis in a single institution from August 2014 to July 2015. We compared those that received preincision bilateral RSB (n=136) with those who received LAI (n=139). The primary outcome was narcotic administration. Secondary outcomes included initial and mean scores, time from anesthesia induction to release, operative time, time to rescue dose of analgesic in the PACU and time to PACU discharge. ResultsTotal narcotic administration was significantly reduced in patients that underwent preincision RSB compared to those that received conventional LAI, with a mean of 0.112 mg/kg of morphine versus 0.290 mg/kg morphine (p<0.0001). Patients undergoing RSB reported lower initial (0.38 vs. 2.38; p<0.0001) and mean pain scores (1.26 vs. 1.77; p<0.015). Time to rescue analgesia was prolonged in patients undergoing RSB compared to LAI (58.93min vs. 41.56min; p=0.047). ConclusionPreincision RSB for TULA in uncomplicated appendicitis in children is associated with decreased opioid consumption and lower pain scores compared with LAI. As the addition of this procedure only added 6.67min to time under anesthesia, we feel that it is a viable option for postoperative pain control in pediatric single-incision laparoscopic surgery. Retrospective comparative studyLEVEL III EVIDENCE.

Single-Incision Versus Three-Port Laparoscopic Appendectomy: Short- and Long-Term Outcomes.

To compare the outcome of patients who had undergone single-incision laparoscopic appendectomy (SILA) with others who had undergone three-port laparoscopic appendectomy (3-PORT). Data from all adults with uncomplicated appendicitis treated by laparoscopic appendectomy between June 2012 and December 2015 were prospectively collected. Patients with chronic pain, appendix malignancy, at least two previous laparotomies, and those undergoing concomitant surgery for different condition were excluded from analysis. Postoperative pain was assessed by a visual analog scale (VAS). Patients were reviewed postoperatively at 7 days and 1 month in the outpatient clinic. Late complications were assessed with a telephonic interview. A total of 91 patients were included (46 SILA; 45 3-PORT). There were 16 males and 30 females in the SILA group (mean age = 26.76 ± 10.58 years) and 18 males and 27 females in the 3-PORT group (mean age = 26.84 ± 10.79 years). The mean operative time for SILA was 48.54 ± 12.80 min, for the 3-PORT group the mean operative time was 46.33 ± 15.54 min (P = 0.46). No case required conversion. Mean postoperative hospital length of stay was 1.87 ± 0.69 days for SILA and 2.38 ± 1.11 days for 3-PORT (P = 0.01). VAS value of 3.91 ± 1.96 and mean ketorolac usage of 0.38 ± 0.65 in 3-PORT group and SILA patients reported 3.70 ± 1.58 and 0.39 ± 0.58, respectively (P = 0.91). Our mean follow-up in SILA group was 25.75 ± 10.82 months, for 3-PORT group the mean follow-up was 26.9 ± 11.8 months. Eleven patients missed long-term follow-up. No incisional hernia was found. There is a statistically significant difference in cosmetic evaluation in favor of SILA (P < 0.005). There was no difference in operative time, early complications, postoperative pain, analgesia requirement between SILA and 3-PORT laparoscopic appendectomy, but after SILA procedure discharge was quicker and long-term cosmetic satisfaction was superior.

EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy