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

Abstract

Background The glove single-port laparoscopic appendectomy is a novel single incision laparoscopic technique (SILT) which is extremely cheaper than the other commercial devices. Objective This study aimed to compare conventional laparoscopic appendectomy (CLA) and glove single port laparoscopic appendectomy (GSPLAP) in adolescents performed under spinal anaesthesia (SA). Patients and Methods 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. Results 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. Conclusion 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.