Port Laparoscopic Appendectomy Research Articles

Single-Incision Laparoscopic Appendectomy

Single-Incision Laparoscopic Appendectomy

Transumbilical single port laparoscopic appendectomy using basic equipment: a comparison with the three ports method

PurposeSingle port laparoscopic surgery is a rapidly evolving laparoscopic surgical approach. We report a comparison of transumbilical single port laparoscopic appendectomy (TUSPLA) and conventional laparoscopic appendectomy (CLA) in a Korean military hospital.MethodsThis single-center retrospective study of 63 patients who received laparoscopic appendectomy was conducted between May 2011 and October 2011. Nineteen patients received TUSPLA and 44 patients received CLA. Clinical outcomes such as operation time, hospital stay, postoperative pain, diet, and postoperative complication were reviewed.ResultsThere were no statistically significant differences between TUSPLA and CLA patients, respectively, in operation time (58.9 minutes vs. 52.3 minutes, P = 0.262), duration of hospitalization (10.2 days vs. 10.6 days, P = 0.782), mean visual analogue scale score (2.6 vs. 2.5, P = 0.894), and return to diet (1.6 days vs. 1.7 days, P = 0.776). There were two cases (10.5%) of short-term complications in the TUSPLA group and four cases (9.1%) of short-term complications in the CLA group. All patients were fully recovered at discharge.ConclusionTUSPLA is a feasible alternative for CLA. When a glove port is used, no special instruments are needed. Thus, it can be performed in a hospital equipped with basic laparoscopic surgical instruments.

Single-port laparoscopic appendectomy: Prospective study of 30 cases

Background: Since the introduction of the laparoscopic appendectomy, it has become an alternative method of treatment to an open appendectomy because of less pain, less abdominal scarring, and quick recovery to daily life. Looking for ways to take advantage of the benefits of laparoscopic surgery has led some surgeons to start performing appendectomy utilizing the single incision laparoscopic surgery. Methods: 30 patients (12 males, 18 females) underwent single port laparoscopic appendectomy using the Covidien port through an incision of 2cm made just infraumbilical. With the use of ligasure for dissection and extracorporeal knot for the stump the appendix was removed. Results: All the 30 patients with age rangingfrom 18 to 50 years were successfully operated upon. The operative time range was 50 to 80 minutes. All were discharged 24 hours after operation. 2 patients (6, 66%) presented with postoperative complications, one case with umbilical wound infection and the other with postoperative pelvic collection. Conclusion: Single port laparoscopic appendectomy is feasible and safe in acute appendicitis without mass or abcess formation.

ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

Valoración del resultado estético percibido por los pacientes apendicectomizados vía laparoscópica mediante tres incisiones

Introduction The aesthetic result has lately been used in General Surgery as an argument for the development of new approaches. On numerous occasions attempts have been made to evaluate the perception that the patients themselves have after their operation by whatever approach, with the aim of finding where we differ and if there is a real option for improvement. The objective of this study was to analyse, using a simple questionnaire, the assessment of the aesthetic results as perceived by patients after appendectomy, and to attempt to determine what are the variables involved in an aspect so subjective as this. Patients and method The variables collected were: age, sex, time since operation, infection of surgical wound, and presence of a drainage, as well as the responses on the aesthetic result of 70 patients who had a 3-port laparoscopic appendectomy. Results Infection of the surgical wound, as well as the age of the patients and the time since the operation determined statistically significant differences in their opinions as regards the number, size and overall aesthetic result of the laparoscopic appendectomy. The median overall satisfaction of the aesthetic result was 9 on a scale from 0 to 10. Conclusions The assessment of the aesthetic result by patients after a 3-port laparoscopic appendectomy is good and is difficult to improve. It is recommended to prevent infection of the three ports after the intervention to obtain better results.

Evaluation of the aesthetic results perceived by patients after 3-port laparoscopic appendectomy

IntroductionThe aesthetic result has lately been used in General Surgery as an argument for the development of new approaches. On numerous occasions attempts have been made to evaluate the perception that the patients themselves have after their operation by whatever approach, with the aim of finding where we differ and if there is a real option for improvement.The objective of this study was to analyse, using a simple questionnaire, the assessment of the aesthetic results as perceived by patients after appendectomy, and to attempt to determine what are the variables involved in an aspect so subjective as this. Patients and methodThe variables collected were: age, sex, time since operation, infection of surgical wound, and presence of a drainage, as well as the responses on the aesthetic result of 70 patients who had a 3-port laparoscopic appendectomy. ResultInfection of the surgical wound, as well as the age of the patients and the time since the operation determined statistically significant differences in their opinions as regards the number, size and overall aesthetic result of the laparoscopic appendectomy. The median overall satisfaction of the aesthetic result was 9 on a scale from 0 to 10. ConclusionsThe assessment of the aesthetic result by patients after a 3-port laparoscopic appendectomy is good and is difficult to improve. It is recommended to prevent infection of the three ports after the intervention to obtain better results.

Single port laparoscopic appendectomy: are we pursuing real advantages?

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.

Laparoscopic vs Transumbilical Single-Port Laparoscopic Appendectomy; Results of Prospective Randomized Trial

Purpose: Conventional three-port laparoscopic appendectomy (LA) is more commonly performed than transumbilical single port laparoscopic appendectomy (TUSPLA). In this report, we performed a prospective randomized study comparing the outcomes of LA and TUSPLA. Methods: Between April 14, 2009 and June 10, 2009, 40 patients who required laparoscopic appendectomies were randomly selected to receive either a TUSPLA or a LA. None of these patients had perforation or abscess. Twenty of the patients received a LA and the other 20 received a TUSPLA. The clinical outcomes and visual analog pain scores (VAS) were compared between the groups. Results: The TUSPLA procedures were performed successfully in every indicated patient. Clinical outcomes were similar in both study groups. The TUSPLA group showed a significantly higher VAS score 24 hours postoperatively than the LA group. Conclusion: Compared with LA, TUSPLA was technically feasible and safe in patients with non-complicated appendicitis. However, the patients in the TUSPLA group reported more postoperative pain than those in the LA group. (J Korean Surg Soc 2010;78:213-218)

Apendicectomía y colecistectomía "invisibles": Cirugía totalmente laparoscópica por un puerto umbilical (OPUS)

Scarless Appendectomy and Cholecystectomy: One port transumbilical laparoscopic surgery Laparoscopic surgery is evolving to less invasive techniques. Thanks to new surgical advances, it is possible to insert into the abdominal cavity multiple instruments through a single device. One option is Triport ® . We report two patients who underwent to an appendectomy and a cholecystectomy, respectively, performed through a single umbilical port. The procedures were successfully performed without complications. Patients were treated on an outpatient basis, according to the fast track concept. Therefore, single port laparoscopic transumbilical appendectomy and cholecystectomy are feasible and safe procedures that require proper training and specially designed surgical instruments.

A Case of Single Port Laparoscopic Appendectomy and Cholecystectomy in a Fresh Cadaver: A Feasible Procedure

We performed single port transumbilical appendectomy and cholecystectomy using the TriPort (R-port, Advanced Surgical Concepts, Wicklow, Ireland), inserted through a transumbilical incision in a cadaver model. A articulating instrument, Autonomy (Cambridge Endo, MA, USA) in right hand was used for retraction in addition to a standard laparoscopic instrument in left hand for dissection and coagulation. Both procedures were technically successful. In conclusion, single port surgery may be performed safely. And in the near future, more complex procedures could be performed through single port in accordance with the advancement of the instruments.

Laparoscopy-Assisted Appendectomy via the patent umbilical ring (Umbilical hernia): A Case Report

Umbilical hernia aswell as acute appendicitis are two of the most common problems seen by paediatric surgeons, although rarely simultaneously. When detected the operative approach is adjusted. We perform the a laparoscopically assisted appendectomy trough through the an excised umbilical hernia sac opening. The operative technique is presented. The most important advantages are single general anesthesia for the two surgical procedures and the use of present openingpatent umbilical ring as an access to inflamed appendix, what is the essence of a minimally invasive surgery,. Evaluating the results of the appendectomy superior cosmetic end result, minimal scaring and lower stress index are the advantages in comparisoncompared to the conventional open surgery. Shorter procedure and reduced costs are the advantages in comparison to the three port laparoscopic appendectomy. Efficacy and safety are the same as in single umbilical hernia repair. Keywords : Umbilical hernia, appendicitis, laparoscopically assisted appendectomy. African Journal of Paediatric Surgery Vol. 4 (1) 2007: pp. 51-54

Two-Port Versus Three-Port Laparoscopic Appendectomy in Children with Uncomplicated Appendicitis

Background/Objective: Laparoscopic appendectomy is commonly performed through a 3-port technique. We compared our experience of 2-port laparoscopically assisted appendectomy with 3-port LA (laparoscopic appendectomy) in uncomplicated appendicitis in terms of efficacy, safety, and cost. Methods: We evaluated 86 children ages 3 to 12 years with uncomplicated appendicitis undergoing laparoscopic appendectomy (2-port, n = 45; 3-port, n = 41) during a 4.5-year period. The technique depends on the surgeon's preference and the position of the appendix. We excluded all children (2-port, n = 8; 3-port, n = 15) with complicated appendicitis. Results: There were no differences at the time of presentation in age, gender, weight, duration of symptoms, or severity of disease for both techniques of laparoscopic appendectomy. In 2-port laparoscopically assisted appendectomy, the operative (40 vs. 68 minutes, P < .05) and anesthesia (67 vs. 96 minutes, P < .05) times were shorter. The average postoperative stay (2.5 days in 2-port vs. 3.3 days in 3-port) and analgesia requirement were also less in 2-port laparoscopically assisted appendectomy. Two children (3-port laparoscopic appendectomy) required conversion to open appendectomy. There were no postoperative complications in either group. The extra cost of endo-loops with 1 port and the 1-day hospital stay was saved by using 2-port laparoscopically assisted appendectomy. Conclusion: We concluded that 2-port laparoscopically assisted appendectomy is a safe and effective alternative for the management of uncomplicated appendicitis. When successful, the overall cost is less with 2-port laparoscopic appendectomy because it is quicker to perform, requires less anesthesia time and no endo-loops, endo-clips, or endo-GIA, and results in a shorter hospital stay and less postoperative analgesia.