An observational study to compare single incision laparoscopic appendectomy with conventional multiport laparoscopic appendectomy

Abstract

INTRODUCTIONAcute appendicitis is the most common surgical emergency and carries lifetime risk of 8%. 1 Appendectomy has been the primary treatment of choice for acute appendicitis, and although antibiotics have established some use but surgery remains the treatment of choice. Open surgery, laparoscopic appendectomy and now single port surgery for appendicitis has become routine approach.Laparoscopic surgery also called minimally invasive surgery (MIS), is a modern surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5-1.5 cm) as opposed to the larger incisions needed in laparotomy and considered as gold standard treatment for acute appendicities.2-4 This technique has many advantages over open procedure like reduced pain due to smaller incisions and hemorrhage, and shorter recovery time. But this technique had a limitation of scars after surgery hence a novel technique has evolved called single incision laparoscopic surgery (SILS), preferably in the navel, with advantages of ABSTRACT Background: Appendicitis is the most common intra-abdominal condition requiring emergency surgery and it is approached by laparoscopic procedures. Innovative methods were developed that reduce tissue trauma and offer improved cosmetic results, one of such being the single-incision laparoscopic surgery (SILS) with advantages of reduced postoperative morbidity and almost invisible scar. Methods: 60 patients were included in the study after meeting inclusion criteria and divided into two groups 30 each. One group had undergone single incision laparoscopic appendectomy and other with multiple port laparoscopic appendectomy. Preoperative, intraoperative and postoperative parameters were collected. Data involving patients' demographics, operative time, length of hospital stay and both intraoperative and postoperative complications were collected. Results: The mean duration of surgery in multiple appendectomy was lesser compared to single port appendectomy and values are insignificant (p =0.1844) when compared between the two groups. None of the patients in both the groups did not have any intraoperative complication. Only one patient in single port appendectomy converted to open surgery. The mean postoperative pain VAS score was 2.00 in multiport appendectomy group which was significantly more as compared to 1.60 among single port appendectomy group after 24 hrs. The postoperative complications and the duration of stay in hospital were almost similar in both the groups. The complications observed during follow up in both the cases were minimal and statistically insignificant. Conclusions: The major advantage of SILS is cosmetic satisfaction, while the disadvantages of SILS are longer operative time and higher conversion rate.