Single-incision Laparoscopic Appendectomy for acute Appendicitis using a 10-mm Laparoscope and the Glove Port Technique

Abstract

Objective:To evaluate the single incision laparoscopic appendectomy (SILA) using existing instruments, the 10-mm laparoscope, and glove port technique.Methods:SILA was performed on 16 patients (8 male cases, 8 female cases) between June 2012 and September 2015. A 20-mm incision was made in the umbilicus and a wound retractor was placed. A 10-mm trocar for the laparoscope and two 5-mm trocars were fixed to the three fingers of the latex gloves and it was attached to the wound retractor. Another thin forceps were inserted from right low abdomen.Results:Average age of patients was 32.6 ± 17.7 years. Preoperative average white blood cell was 13,325 ± 4,584 /mm3, and average CRP was 1.81 ± 3.70 mg/dL. Preoperative body temperature was 36.8 ± 0.5°C. The mean appendix size was 9.6 ± 2.3 mm and none of the patients had an abscess on preoperative CT. The CT also revealed a fecal pellet in 5/16 (31%) of patients. Mean operation time was 66.4 ± 25.4 minutes, and minimal intraoperative bleeding was observed in all patients. Average hospital stay was 5.3 ± 1.9 days and none of the patients had complications.Conclusion:SILA using the 10-mm laparoscope and glove port technique may be a safe and feasible operation for mild to moderate appendicitis.

Laparoscopic Appendectomy Using the Surgical-Glove Port Through an Umbilical Incision: A Single-Center Retrospective Study

“…The incidence of acute appendicitis is in the 15-19-year age group [ 19 ], and cosmetic results are significant in this age group [ 23 ]. Pelosi and Pelosi first introduced single-incision laparoscopic surgery (SILS) in 1992 [ 24 ].…”

“…Nonetheless, SILA often demands a higher level of skills and expertise than TLA. Conflict of instruments used, absence of triangulation, and difficult retraction are the main technical issues in minimally invasive single-site surgery today [ 1 , 9 , 23 ]. Many generations of components, access, and retracting technologies have been designed to improve the method to overcome the above-mentioned obstacles [ 9 ].…”

“…Consequently, more recently, SILS with a self-made glove port has been proposed to reduce surgical costs while maintaining aesthetics and effectiveness [ 2 , 3 , 7 , 10 , 11 , 23 ]. It is simple to use and adapts easily to the abdominal wall, even in obese patients.…”

“…Some surgeons invert the appendix stump using the purse-string suture during open appendectomy [ 18 , 25 ], with ENDOLOOP® simple ligation [ 23 ] and stump closure with invaginating suture [ 27 ] to avoid postoperative residual abscess. However, these patients had mild appendicitis according to the AAST classification [ 15 ].…”

Homemade Glove Port for Single-Incision Pediatric Endosurgery (SIPES) Appendectomy—How We Do It

“… 2 9 10 Glove ports rather than traditional ports can be used as a cost-effective method with improved ergonomics to circumvent the limitations of the previous single ports. 4 11 12 13 14 Furthermore, the elasticity and pliability of the surgical glove port compared with commercially available ports allows reasonable range of movements and achieves enough triangulation ( Fig. 4 ).…”