Feasibility and Safety of Single-Incision Laparoscopic Appendectomy by a Surgical Resident under Supervision of a Staff Surgeon

Abstract

This study was aimed at reporting our experience with single-incision laparoscopic appendectomies (SILA) performed by a surgical resident, and to evaluate the safety and feasibility of the procedure, together with a comparison of the outcomes of the same procedure performed by a staff surgeon. Methods:We conducted a retrospective case series analysis of 60 consecutive patients who underwent SILA. Two surgeons, an attending staff surgeon and a second-year surgical resident, performed the SILA procedures. SILA procedures performed by the resident were intraoperatively guided and supervised by the staff surgeon.Results: A total of 60 case-matched patients with acute appendicitis underwent a SILA performed by either the resident or attending staff. There was no difference in patient demographics between the two groups of patients. The mean operation time was longer in the resident group than in the staff group (43.2±6.0 minutes vs. 32.9±10.5 minutes, p<0.001). There was no significant difference in the operative data between the two groups. No conversion to an open procedure occurred in either group. Postoperative pain, time to onset of oral intake, and number of days of postoperative hospital stay were similar in both groups. Conclusion:SILA procedures performed by a resident are safe and feasible despite longer operation times. Perioperative supervision and guidance by an attending staff surgeon may facilitate surgical outcomes.

The Study of Comparison of Single-Incision Laparoscopic Versus Conventional Laparoscopic Appendectomy: A Comprehensive Systematic Review

“…Compared with the traditional three-port approach, single-port laparoscopy has been confirmed to be effective and safe in the treatment of acute appendicitis, along with many other advantages, including less trauma, less pain, shorter hospital stay, and improved cosmetic effect. 18,20,22 Conventional laparoscopic appendectomy (CLA) using three port incisions is accepted as the standard technique for patients with acute appendicitis. CLA has been shown to have several advantages over an open approach, including less surgical trauma, faster recovery, decreased complications, less postoperative pain, and improved cosmetic outcomes.…”