Single-port laparoscopic appendectomy using a needle-type grasping forceps for selective adult patients with acute uncomplicated appendicitis

Abstract

Laparoscopic appendectomy has been performed by surgeons all over the world with the advantages of minimal injury. However, conventional multiple ports procedure still has room for improvement to further reduce surgical stress. We present a novel technique of single-port laparoscopic appendectomy using a needle-type grasping forceps (SLAN) for the treatment of uncomplicated appendicitis in adults, which produces just a 1 cm traumbilical incision. Fourteen adult patients underwent this technique without any complications. Many advantages were observed, including minimal surgical trauma, less pain, faster recovery and unobviousable scars. In conclusion, SLAN provides a new choice of minimal invasive procedure for surgeons to treat adult patients with acute uncomplicated appendicitis.

A brief overview of single-port laparoscopic appendectomy as an optimal surgical procedure for patients with acute appendicitis: still a long way to go

“…Finally, 17 research articles or case series on SPLA, from the Republic of Korea, China, India, Spain, and other countries, were included in the present review. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Most articles were from the Republic of Korea (n ¼ 6), followed by China (n ¼ 4), India (n ¼ 3), Vietnam (n ¼ 1), Argentina (n ¼ 1), Egypt (n ¼ 1), and Spain (n ¼ 1). There were eight retrospective studies, six prospective studies, and three case series (Figure 1).…”

“…Surgical techniques, equipment, and devices, including magnet-assisted single trocar (MAST), needle grasper (Endo Relief)-assisted single-incision laparoscopic appendectomy (NASILA), and SPLA using a needle-type grasping forceps (SLAN) are summarized (Table 1). [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] The performance of each technique was also compared in terms of clinical outcomes (Table 2).…”

“…Traditional laparoscopic trocars have also been used by many teams. 18 , 22 , 26 – 29 Among them, both the single-incision laparoscopic appendectomy using conventional multiport laparoscopic instruments (SILACI), completed by Uday et al., 22 and the SLAN designed at the present authors’ centre (Chaoyang Central Hospital), 27 – 29 were completed using the traditional three-port laparoscopic instruments. Notably, SLAN showed a smaller mean incision length than SILACI (1 cm versus 2.5 cm), which may have been due to needle forceps used at Chaoyang Central Hospital to assist the operation, during which only two 5-mm trocars were required for entry, observation and operation.…”

“… 35 Considering the mild inflammatory status and uncomplicated surgical procedures, SPLA has frequently been performed in patients with uncomplicated appendicitis. 17 , 21 , 25 – 29 Conversely, patients with complicated appendicitis are at higher risk of conversion to laparotomy, for whom strict surgical indications should be adopted. 36 In cases where indwelling abdominal drainage tubes are required (e.g., for appendiceal perforation), the selection of single-port laparoscopic surgery becomes limited.…”

Single-port laparoscopic appendectomy using a needle-type grasping forceps compared with conventional three-port laparoscopic appendectomy for patients with acute uncomplicated appendicitis: a single-center retrospective study

“…In view of this, our center designed and performed a novel minimally invasive surgical technique termed single-port laparoscopic appendectomy using a needle-type grasping forceps (SLAN), which is the first such technique performed worldwide. 4,5 As our previous clinical observations have indicated, SLAN has the advantages of minimal surgical incisions, satisfactory cosmetic results, and positive patient feedback. Evidence-based medical research is important for the safety and feasibility of this novel technique.…”