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

Abstract

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...