Single-Incision Multiport Laparoscopy Does Not Cause More Pain Than Conventional Laparoscopy: A Prospective Evaluation in Children Undergoing Appendectomy

Mayer, Steffi; Werner, Antje; Wachowiak, Robin; Buehligen, Ulf; Boehm, R.; Geyer, Christian; Till, Holger

doi:10.1089/lap.2011.0131

Cited by 16 publications

(9 citation statements)

References 22 publications

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“…Kim et al reported that more intense pain was generated with the SILS technique than with the LA technique [15]. Mayer et al reported that the pain was less severe postoperatively in the SILS group compare with the LA group [16]. In our study there was no statistic difference in postoperative complications between SILS and conventional LA.…”

Section: Discussionsupporting

confidence: 39%

Comparative Study of a Single-Incision Laparoscopic and a Conventional Laparoscopic Appendectomy for the Treatment of Acute Appendicitis in Children

Zitouni¹,

Louati²,

Turki³

et al. 2019

AJCEM

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Appendicitis is the most common indication for urgent surgery in children. Single-incision laparoscopic surgery (SILS) has further improved surgical outcomes. In this study we compared SILS and conventional in terms of peroperative difficulty and outcomes. A retrospective chart review was performed interesting all patients operated for acute appendicitis in the department of pediatric surgery Hedi Chaker hospital and department of surgery Habib Borguiba hospital between January 2006 and December 2016. Among the total of 181 patients, LA and SILS were performed respectively on 51 (28.2%) and 137 patients (71.8%). In 41.9% of patients of conventional LA it was a complicated appendicitis and in 29.8% of SILS group it was a complicated appendicitis (p=0.22). The mean operative time was 63.7 min for the conventional LA group and 71.79 min for the SILS group, it was not statistically significant (p=0.046). Conversion was made in 13.7% of patients in the conventional LA and in 5.8% in patients with SILS (p=0.14). The median length of hospital stay was for the conventional LA group 3.5 days and for SILS group 2.3 days (p=0.04). The current study found that SILS provided comparable surgical outcomes to conventional LA and did not result in increased postoperative complication rates.

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Section: Discussionsupporting

confidence: 39%

Comparative Study of a Single-Incision Laparoscopic and a Conventional Laparoscopic Appendectomy for the Treatment of Acute Appendicitis in Children

Zitouni¹,

Louati²,

Turki³

et al. 2019

AJCEM

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“…Based on such a theoretical basis, Kim et al [10] reported that more intense pain was generated with the SILS technique than with the LA technique. On the other hand, Mayer et al [13] reported that the pain was less severe postoperatively in the SILS group compare with the LA group. No differences were shown between the two groups during a study on pain management regarding wound infection and the number of VAS and painkiller injections.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of a Single-Incision Laparoscopic and a Conventional Laparoscopic Appendectomy for the Treatment of Acute Appendicitis

Kang

Bae

Gwak

et al. 2012

J Korean Soc Coloproctol

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PurposeFor the treatment of acute appendicitis, a conventional laparoscopic appendectomy (LA) has been widely performed. Recently, the use of single incision laparoscopic surgery (SILS) is increasing because it is believed to have advantages over conventional laparoscopic surgery. In this study, we compared SILS and a conventional LA.MethodsWe analyzed the 217 patients who received laparoscopy-assisted appendectomies between August 2010 and April 2012 at Inje University Sanggye Paik Hospital. One hundred-twelve patients underwent SILS, and 105 patients underwent LA. For the two groups, we compared the operation times, postoperative laboratory results, postoperative pain, hospital stay, and postoperative complications.ResultsThe patients' demographics, including body mass index, were not significantly different between the two groups. There were 6 perforated appendicitis cases in the SILS group and 5 cases in the LA group. The mean operative time in the SILS group was 65.88 ± 22.74 minutes whereas that in the LA group was 61.70 ± 22.27 minutes (P = 0.276). There were no significant differences in the mean hospital stays, use of nonsteroidal antiinflammatory drugs, and wound infections between the two groups.ConclusionPostoperative pain, complications and hospital stay showed no statistically significant differences between the SILS and the LA groups. However, our SILS method uses a single trocar and two latex tubes, so cost savings and reduced interference during surgery are expected.

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“…24 There is only one study that prospectively used postoperative pain scores in children who underwent either single-incision appendectomy or TPLA. 28 The investigators found no difference in pain scores at 8, 16, 24, 48, and 72 hours postoperatively. Interestingly, they also found that single-incision appendectomy required significantly less analgesic medication (paracetamol and/or metamizole) per kilogram (65.73 mg/kg) compared with TPLA (103.39 mg/ kg).…”

Section: Postoperative Pain Controlmentioning

confidence: 91%

“…The breadth of the data presented here comes from our own prospective randomized trial of 360 children with nonperforated appendicitis and from three other retrospective studies comparing single-incision appendectomy to TPLA in children. 15,16,24,28 All values represent the mean unless otherwise stated.…”

Section: Comparison Between Techniquesmentioning

confidence: 99%

“…The two other retrospective studies, which also include smaller sample sizes (55 and 39 patients), failed to demonstrate any difference in operative time with the larger series having a mean operative time of 46.2 minutes for TPLA versus 40.5 minutes for single-incision appendectomy and the other being 68.5 versus 66.2 minutes, respectively. 16,28 Our prospective trial is the only pediatric study that has directly compared patient charges. While total hospital charges were higher in the single-incision group ($17,600 vs. $16,600, p ¼ 0.005), when we corrected for the cost of using a stapler, there was no difference ($16,800 vs. $16,600, p ¼ 0.6).…”

Section: Operative Time and Costmentioning

confidence: 99%

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The Minimally Invasive Approach to Appendectomy: Is Less Better?

Iqbal

Ostlie

2012

Eur J Pediatr Surg

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The benefits of the three-port laparoscopic appendectomy (TPLA) are now appreciated. Included in these advantages are reduced postoperative pain, reduced hospitalization, early return to routine activities, and a definite cosmetic benefit over the open approach. Recently, the single-incision laparoscopic technique for several disease processes has been popularized. The single-incision approach through the umbilicus is ideally suited for patients with nonperforated appendicitis. This article will review our operative technique for both the TPLA and single-incision laparoscopic appendectomy, and then review the available literature that compares benefits of one approach over the other. When comparing these two approaches, variables that will be discussed include infectious complications, operative time and cost, and the need for postoperative pain medication.

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Single-Incision Multiport Laparoscopy Does Not Cause More Pain Than Conventional Laparoscopy: A Prospective Evaluation in Children Undergoing Appendectomy

Cited by 16 publications

References 22 publications

Comparative Study of a Single-Incision Laparoscopic and a Conventional Laparoscopic Appendectomy for the Treatment of Acute Appendicitis in Children

Comparative Study of a Single-Incision Laparoscopic and a Conventional Laparoscopic Appendectomy for the Treatment of Acute Appendicitis in Children

Comparative Study of a Single-Incision Laparoscopic and a Conventional Laparoscopic Appendectomy for the Treatment of Acute Appendicitis

The Minimally Invasive Approach to Appendectomy: Is Less Better?

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