Single-incision videolaparoscopic appendectomy with conventional videolaparoscopy equipment

Abstract

BackgroundAcute appendicitis is the most common surgical emergency in daily practice, and is approached laparoscopically in many centers. Efforts have been undertaken for the development of minimally invasive techniques that reduce tissue trauma and offer improved cosmetic results, one of such being the single-incision laparoscopic surgery (SILS).AimTo present a minimally invasive technique for appendectomy (SILS) undertaken with conventional instruments.MethodEleven patients were treated in the emergency care center presenting abdominal pain in the right iliac fossa that was suggestive of appendicitis. Diagnostic investigation was subsequently conducted, including physical examination, laboratory and imaging exams (CT scan with intravenous contrast or total abdominal ultrasound), and the results were consistent with acute appendicitis. Thus, after consent, these patients underwent SILS appendectomy under general anesthesia with three trocars (two 10 mm and one 5 mm), using conventional and optical laparoscopic tweezers (10 mm, 30º). The base and pedicle of the appendix were ligated with titanium LT 400 clips. The procedure occurred uneventfully. Inclusion criteria were absence of diffuse peritonitis, BMI (body mass index) less than 35 and absence of serious comorbidities or sepsis.ResultsSeven men and four women were operated with average age of 25.7 years and underwent appendectomy through this technique. Mean procedure duration was of 37.2 min. Regarding surgical findings, three had appendicitis in stage 1, four in stage 2 and four in stage 3. All patients improved well, without surgical complications, and did not require conversion to open surgery or conventional laparoscopy technique.ConclusionAppendectomy conducted through Single Incision Laparoscopic Surgery is a feasible and promising technique that can be performed with conventional laparoscopic instruments.

Da vinci SILS-appendectomy for appendiceal endometriosis secondary to stage IV endometriosis: a case report and review of literature

“…13 Successful operations using DILA urged the push for SILS, as stated previously, primarily for cosmetic reasons. 11 In direct comparison to traditional laparoscopic appendectomy, SILS appendectomy can be conducted with comparable operative times, lengths of stay, and procedural complications, and with superior cosmetic outcomes -the main downside noted being the cost. 14,15 As reported in this case, the use of SILS can be easily manipulated using conventional laparoscopic instruments.…”

“…A previous study outlined SILS appendectomy utilizing three trocars (two 10mm and one 5mm), using conventional and optical laparoscopic tweezers (10 mm, 30˚); while using titanium LT 400 clips to ligate the base and pedicle of the appendix. 11 As described earlier, the SILS procedure can be applied to appendectomy in female patients suffering from endometriosis. A previous study performed to evaluate deeply located endometriosis showed significant involvement of the appendix.…”

“…2,6,10 Current applications for the procedure include, but are not limited to: tubal ligation, hysterectomy, appendectomy, cholecystectomy, gastrectomy, colectomy, and nephrectomy. 11 The procedure is gaining traction because of reduced post-operative pain or complications, and cosmetic advantages. 11 We present a case report of a patient with stage IV appendiceal endometriosis managed with Da Vinci RA-SILS appendectomy and a literature review.…”

“…11 The procedure is gaining traction because of reduced post-operative pain or complications, and cosmetic advantages. 11 We present a case report of a patient with stage IV appendiceal endometriosis managed with Da Vinci RA-SILS appendectomy and a literature review.…”

Three port laparoscopic appendectomy technique with low cost and aesthetic advantage

“…The technique of single umbilical access is feasible for the appendectomy, and has better aesthetic appeal in relation to the multiple visible incisions in the abdominal wall 8 , 11 , 14 , 17 , 24 , 25 , 26 , 29 . The incisional access needs to be wider, and may become visible or can deform the patient's umbilicus.…”