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

Abstract

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)

A comparative study between single incision laparoscopic appendectomy and conventional laparoscopic appendectomy

“…Mean number of intravenous doses required was 1.4 in the SILS group and 1.2 in the CLA group and this difference in the analgesic requirement of the two groups was not statistically significant (p>0.05). Data published by Park JH et al 20 was in concordance with our study. In this study SILS group required 1.6 mean IV doses while CLA required 1.4 IV doses.…”

Technical approaches to single port/incision laparoscopic appendicectomy: a literature review

“…The highest rates, however, were reported in papers using the 'SPILA unassisted' technique (2/10, 20%). 13 There were six intra-abdominal abscesses across all of the studies: five were reported in four 'SPILA unassisted' papers 9,11,19,21 and one in a 'hybrid' paper. 29 In total, complication rates appear to be highest for those procedures in which SPILA is not assisted by sutures or wire.…”

“…Rothenburg et al placed a 3mm single instrument through a separate stab wound incision or 3mm port suprapubically to aid the SPILA procedure. 12 Palanivelu et al achieved successful SPILA The 'surgical glove' method (in which trocars are placed through the holes of a surgical glove with cut fingertips and the 'device' is subsequently applied to a retractor inserted into the abdomen through a single transumbilical incision) was described by Park et al, 19 Kim et al 20 and Lee et al 21 in 20, 43 and 75 patients respectively (Fig 2). The surgical glove can be considered an improvised multi-luminal single port device.…”

“…Twenty studies [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] including 584 patients met the definition criteria for 'SPILA unassisted' approaches. The use of special multi-conduit ports was reported in four studies [4][5][6][7] ( Fig 1).…”

Single Incision versus Conventional Multiport Laparoscopic Appendectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Twelve Potentially appropriate RCTs comparing SILA and CMLA were identified [10,11,12,13,14,15,16,17,18,19,20,21]. Among them, one study that applied a laparoscopic-assisted extracorporeal appendectomy technique was excluded [10].…”