Transumbilical Laparoscopic-Assisted Appendectomy (TULAA): A Safe and Useful Alternative for Uncomplicated Appendicitis

Abstract

TULAA is the best approach in uncomplicated appendicitis. It is less invasive and traumatic, permits a complete evaluation of the peritoneal cavity with superior cosmetic results, especially in obese patients and in cases of ectopic appendicitis.

Single-port laparoscopic repair of a perforated duodenal ulcer: intracorporeal “cross and twine” knotting

“…With advances in instrumentation and surgical experience, many laparoscopic surgeons have attempted to minimize the number of ports to reduce traces of the operation, and LSPS was borne of these efforts. Various surgical procedures, including appendectomy, cholecystectomy, and adrenalectomy, have been attempted with LSPS, which presents certain advantages such as minimal scarring, less incisional pain, and the ability to add another trocar to perform multiport surgery [5][6][7][8]. The technique has attracted many laparoscopic surgeons.…”

“…This approach offers better cosmetic results (scarless abdominal surgery via umbilical incision), less incisional pain, and the capability to convert to multiport surgery if required [5][6][7][8]. However, making a ''knot'' when using the LSPS technique was more time-consuming and challenging than when using the conventional multiport laparoscopic technique to treat a perforated duodenal ulcer.…”

Transumbilical endoscopic surgery: a preliminary clinical report

“…Usually a rigid laparoscope with a working channel was used in this technique. The appendix was pulled out through the umbilical port by using a grasper inserted through the channel and removed extracorporeally [10,11]. Cuesta et al [12] recently introduced a transumbilical scarless cholecystectomy technique in ten patients with gallstones.…”

Transumbilical laparoscopically assisted appendectomy in children

“…Although port site infection was 2.5 times higher in the TULAA group (13.7% versus 4.6%), that difference did not reach statistical significance. In TULAA procedures, Koontz et al [12] reported a wound site infection rate of 6.3%, D'Alessio et al [4] 4%, Meyer et al [16] 3.6 %, and Pappalepore et al [19] only 1.5%.…”