A Double-Blinded Randomized Controlled Trial of Laparoendoscopic Single-Site Access Versus Conventional 3-Port Appendectomy

Teoh, Anthony Yuen Bun; Chiu, Philip Wai Yan; Wong, Thomas K. F.; Poon, Michael Chi Ming; Wong, SK; Leong, Hio Teng; Lai, Paul B.S.; Ng, Enders Kwok Wai

doi:10.1097/sla.0b013e3182765fcf

Cited by 92 publications

(114 citation statements)

References 16 publications

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“…Another two study reported significant difference on pain score in favor of the SILA group during the first 24 h [21,22]. Teoh et al [16] described no significant differences in pain score when evaluated at rest but a decrease in this score in the CLA group during coughing and standing. As many patients felt pain after surgery, it is difficult to conclude precisely on whether or not there is less post-operative pain.…”

Section: Discussionmentioning

confidence: 97%

“…A single patient suffered an intra-abdominal abscess, occurring in the three-port group. According to the several studies conducted by Teoh et al, Frutos et al, Sozutek et al and Lee et al [14,16,19,21] showed patient complications were similar between groups the results for SILA and 3PLA groups revealed no significant difference despite some fewer complications in each groups.…”

Section: Complicationsmentioning

confidence: 96%

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Can Single Incision Laparoscopic Appendectomy Replace the Traditional Three Port Laparoscopic Approach in Coming Future: A Review

Chand¹,

Ling²

2015

Surgery

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Journal of Surgery[ IntroductionMedicine is an ever-changing and ever-growing field where day after day and year after year new things are invented, applied for the treatment of various diseases. In the line of treatment, surgery has been one of the feared treatment options for most of the patients; therefore surgeons try to provide the patients with the best possible surgical treatment options. The best possible surgical option has always been the one with the lesser complications intra and postoperatively, wellcontrolled pain, less stay at hospital etc. Both doctors and patient don't want to maximize hospital stay as one study stated that extended hospital stay has been associated with increased incidence of hospital acquired infections, which causes further increase in morbidity and mortality [1]. One of the greatest achievements in the history of surgery has been evolved from open surgical techniques to the operative video-laparoscopy Acute appendicitis is one of the most common cause of acute abdomen and one of the most common surgical emergencies. Appendectomy for acute appendicitis is one of the most commonly performed surgical procedures [2]. The surgical technique of first open appendectomy (OA) was performed by Dr. Charles Mcburney in and this approach has not significantly changed in the last 1 century [3]. In 1983, Dr. Kurt Semm, performed first minimally invasive laparoscopic appendectomy, thereafter LA has become the standard of practice in uncomplicated appendectomies in most minimally invasive institution [4]. In the past few years of minimally invasive surgery, LESS, NOTES has gained popularity. SILA was first described in 1998 by Esposito and has gained popularity as a method with a concept of ''scarless'' abdomen [5]. While Pelosi in 1992 performed the first SILA for acute appendicitis [6]. Innovative methods such as NOTES (Natural Orifice Tran luminal Endoscopic Surgery) and single incision laparoscopy (SIL) have demonstrated promissory results in various surgical procedures, appendectomy among them [7]. According to a recent study, SILA resulted in faster recovery than conventional 3-port LA [8]. However in some other studies it has also been reported that SILS is associated with a longer operative time and higher postoperative pain scores, and that patients need more analgesics to feel comfortable [9]. NOTES, SILS, and robotic surgery do not constitute techniques, rather they are concepts, hence regarded as transitions from laparoscopic surgery to unknown fields of minimally invasive therapeutic modalities [10]. SILS was recommended as a possible alternative of the traditional laparoscopic surgery via four ports for the biliary tact by Navarra et al. [11]. With NOTES having a diminished success, because of the inability to find a clean site for access, thereby increasing the chances of intra-abdominal spillage or infection from the incision [12] increased interest has been seen in SILS. SILS occupies a space between NOTES and standard laparoscopy [13]. There have been several studies regard...

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Section: Discussionmentioning

confidence: 97%

Section: Complicationsmentioning

confidence: 96%

Can Single Incision Laparoscopic Appendectomy Replace the Traditional Three Port Laparoscopic Approach in Coming Future: A Review

Chand¹,

Ling²

2015

Surgery

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“…They concluded that hospitalization was for a similar period in both groups, whereas in our study SILA patients required lesser hospitalization than CLA patients. 13 Teoh et al concluded that all variables were comparable in both groups, but found that SILA patients complained of pain on stress eg. Coughing (p=0.001).…”

Section: Discussionmentioning

confidence: 99%

Single incision laparoscopic appendicectomy versus conventional laparoscopic appendicectomy- a prospective study

2017

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Background: The advent of Single incision laparoscopic appendicectomy (SILA) has encouraged surgeons to compare its benefits over conventional laparoscopic appendicectomy (CLA). We conducted a prospective study comparing SILA with CLA, evaluating parameters like operative time and complications, post-operative pain, duration of stay and the cosmetic outcome.Methods: A prospective, comparative study of 94 consecutive patients was conducted at our institution between December 2014 and May 2016. The data regarding the various parameters were documented in both groups of patients.Results: Among the 94 patients, 30 underwent SILA and 64 underwent CLA. We found statistically significant outcomes for SILA over CLA in variables such as operative time (p=0.0018), duration of hospital stay (p≤0.0001) and cosmetic outcome (p≤0.0001). Almost all patients in the SILA category showed no evidence of a scar after a three month follow up.Conclusions: SILA was found to have a better outcome than CLA with regard to operative time, hospital stay and cosmesis. We conclude that this technique of SILA can be a better alternative to CLA.

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“…Endoscopic Surgery) and single incision laparoscopy (SIL) have demonstrated promissory results in various surgical procedures, appendectomy among them 7,[14][15][16] . There are many articles that report the experience with laparoscopic appendectomy by SIL, the majority of which are series and case reports.…”

Section: Innovative Methods Such As Notes (Natural Orifice Transluminalmentioning

confidence: 99%

“…this evolution was the development of laparoscopic procedures, which would become the standard of reference for multiple procedures 7,[14][15][16] . This development has generated various benefits for patients, fact that is observed as evidence during post-surgey 20 .…”

Section: Acta Cirúrgica Brasileira -Vol 29 (12) 2014 -829mentioning

confidence: 99%

Single-incision laparoscopic appendectomy versus conventional laparoscopy in adults. A systematic review

2014

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PURPOSE:To determine the best treatment option for not complicated acute appendicitis (AA) in adult patients, between single incision laparoscopy (SIL) and conventional laparoscopy (CL), measured by morbidity associated with disease.METHODS: Systematic review. Articles of adults diagnosed with AA treated by SIL or CL were analyzed. Databases included:MEDLINE, LILACS, IBECS, Web of Science, Scopus and Cochrane, using MeSH terms and free words. The studies were analyzed using the MINCIR methodology. Variables included: conversion rate, morbidity, hospital stay, surgery duration, and methodological quality (MQ) of primary studies. Averages, medians and weighted averages were calculated. RESULTS:Thirteen articles were analyzed. For SIL and CL the conversion rate were 3.4% and 0.7 %, the morbidity were 8% and 6.5%, the hospital stay were 2.5 and 2.8 days, the surgery duration were 53.4 and 53.8 minutes, and the MQ were 14.3±6.6 and 16.0±6.9 points, respectively. CONCLUSION:With the exception of the conversion rate, there are no differences between single incision laparoscopy and conventional laparoscopy for the treatment of acute appendicitis in adults.

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A Double-Blinded Randomized Controlled Trial of Laparoendoscopic Single-Site Access Versus Conventional 3-Port Appendectomy

Cited by 92 publications

References 16 publications

Can Single Incision Laparoscopic Appendectomy Replace the Traditional Three Port Laparoscopic Approach in Coming Future: A Review

Can Single Incision Laparoscopic Appendectomy Replace the Traditional Three Port Laparoscopic Approach in Coming Future: A Review

Single incision laparoscopic appendicectomy versus conventional laparoscopic appendicectomy- a prospective study

Single-incision laparoscopic appendectomy versus conventional laparoscopy in adults. A systematic review

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