Laparoscopic appendectomy using only two 5 mm trocars

Bonatti, Hugo

doi:10.1007/s10353-017-0465-1

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…In one patient in group 2, LA was done with only two 5-mm ports and no minigrasper due to favorable anatomy with the appendix being adhered to the right lateral abdominal wall [6]. In another two port LA case, a 5-mm and 10/12-mm trocar were inserted and the appendix was suspended with a Keith needle in the RLQ (Figures 4(a), 4(b), 4(c), and 4(d)).…”

Section: Resultsmentioning

confidence: 99%

“…Using an endoloop to tie off the appendix stump has been shown to be safe, and thus the use of a 10-mm port for the stapler can be avoided [5]. Various techniques to reduce the number [6, 7] and size of ports during LA have been published, and in children mini-instruments are commonly used [8, 9]. In adults use of a suture to suspend the appendix has been suggested by Roberts et al [7].…”

Section: Introductionmentioning

confidence: 99%

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Development of a Two Port Laparoscopic Appendectomy Technique at a Rural Hospital

Bonatti

2019

Minimally Invasive Surgery

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Background. Laparoscopic appendectomy (LA) is most commonly performed using two 5-mm and one 10/12-mm ports. Various attempts to reduce the number and size of ports have been made and new technologies such as single port LA have been introduced. Appendix and mesoappendix are usually divided with a stapler or energy device with electrocautery, clips, and endoloop being cheaper options. Patients and Methods. This study includes 51 consecutive LAs performed at a rural hospital. Patients were divided into 4 groups: group 1 was the standard technique group (n=12), group 2 served as a “try-out” (n=12), group 3 served as feasibility group (n=12), and group 4 was the final patient cohort in which the optimized technique was preferably used (n=15). Results. Median age of the study cohort was 35.4 (range: 6.2-80.6) years, and 55% of patients were male. Whereas in G1 all patients had standard port placement (10/12-mm, 2x5-mm), in an increasing number of patients in G2-4 only two 5-mm ports and the 2.3-mm Teleflex minigrasper were inserted. Usage of staplers and/or energy devices was reduced from 100% in G1 to 20% in G4, and in the majority of cases both the appendix and the vascular pedicle were secured with an endoloop. The new technique did not add time to the procedure or total OR time. No stump-leaks or surgical site infections were encountered in this series, and there were no conversions to open surgery. Cost savings when not using a stapler or energy device are approximately 400$ per case; the minigrasper added approximately 200$ to the case. Discussion. LA with use of two ports and a portless needle grasper is feasible in the majority of cases and was associated with high patient satisfaction and excellent cosmetic results. Avoiding energy devices and staplers is cost saving; the endoloop securely controls appendix and mesoappendix.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of a Two Port Laparoscopic Appendectomy Technique at a Rural Hospital

Bonatti

2019

Minimally Invasive Surgery

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“…In summarizing the topics of the 39th Annual International Congress of the European Hernia Society, held 24-27 May 2017, in Vienna, Austria -congress president: Rene H. Fortelny, I hope to motivate you to attend the high-quality international scientific meeting [2][3][4][5][6]. Finally, articles in this issue of European Surgery describe novelties regarding esophagogastric (gastric tube formation) [7], colorectal (mortality after emergency surgery) [8], and minimally invasive surgery (two-trocar appendectomy) [9]. May the publications contribute toward enriching your knowledge and surgical skills.…”

Section: Dear Readermentioning

confidence: 98%

Behind and beyond surgery

Riegler¹

2017

Eur Surg

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Laparoscopic appendectomy using only two 5 mm trocars

Cited by 2 publications

References 7 publications

Development of a Two Port Laparoscopic Appendectomy Technique at a Rural Hospital

Development of a Two Port Laparoscopic Appendectomy Technique at a Rural Hospital

Behind and beyond surgery

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