Single-incision laparoscopic appendectomy for acute appendicitis: a preliminary experience

Chouillard, Élie; Daché, A.; Torcivia, Adriana; Helmy, Nada; Ruseykin, Ivan; Gumbs, Andrew A.

doi:10.1007/s00464-009-0860-1

Cited by 51 publications

(33 citation statements)

References 30 publications

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“…Twenty studies [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] including 584 patients met the definition criteria for 'SPILA unassisted' approaches. The use of special multi-conduit ports was reported in four studies [4][5][6][7] ( Fig 1).…”

Section: Spila Unassistedmentioning

confidence: 99%

“…Techniques placing multiple ports through closely spaced fascial incisions with a single abdominal skin incision were reported in ten studies. [8][9][10][11][12][13][14][15][16][17] Generally, papers described the introduction of three trocars through the fascia, two providing channels for instruments and one providing access for a 5-10mm laparoscopic camera with an angulated lens. In studies where three ports were not placed, a third instrument, often a grasper, was placed directly though a fascial stab incision.…”

Section: Spila Unassistedmentioning

confidence: 99%

“…8,9 A single study used only two 5mm ports, though which a 4mm 30º camera, bipolar cautery and absorbable suture material could be placed. 10 The authors enlarged one of their port sites to retrieve the appendix.…”

Section: Spila Unassistedmentioning

confidence: 99%

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Technical approaches to single port/incision laparoscopic appendicectomy: a literature review

Rehman¹,

Ahmed

2011

annals

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INTRODUCTION Single port/incision laparoscopic surgery (SPILS) is a modern advancement toward stealth surgery. Despite the paucity of high-quality scientific studies assessing its effectiveness, this procedure is being used increasingly. This review aims to describe commonly used techniques for SPILS appendicectomies (SPILA), to summarise complication rates in the literature and to provide discussion on indications and implementation. METHODS All available databases including the Cochrane Central Register of Controlled Trials, MEDLINE ® and Embase ™ were searched in February 2011 and cross-referenced for available English literature describing SPILA in patients of any age. RESULTS Three broad technical approaches are described: procedures using laparoscopic instruments through a single skin incision in the abdominal wall, regardless of the number of fascial incisions, with or without the additional use of percutaneous sutures or wires to 'assist' the operation, and hybrid procedures, in which the appendix is exteriorised using a single incision laparoscopically assisted operation but subsequently divided using a conventional 'open' appendicectomy technique. Complication rates seem to be highest in SPILA procedures unassisted by sutures or wires. CONCLUSIONS Future research assessing the efficacy of single incision laparoscopic procedures should consider variation in technique as a possible factor affecting outcome.

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Section: Spila Unassistedmentioning

confidence: 99%

Section: Spila Unassistedmentioning

confidence: 99%

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Technical approaches to single port/incision laparoscopic appendicectomy: a literature review

Rehman¹,

Ahmed

2011

annals

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“…4,[12][13][14][15][16][17][18] But the successive rate of SILS technique can be confirmed by prospective clinical trial but no study was found yet.…”

Section: Discussionmentioning

confidence: 98%

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

et al. 2016

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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.

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“…20 They found lower pain scores and better cosmesis in the SILS group and felt that it was a suitable alternative to standard laparoscopic appendicectomy in uncomplicated cases of appendicitis despite the additional time required.…”

Section: Appendicectomymentioning

confidence: 93%

Single incision laparoscopic surgery in general surgery: a review

Greaves

Nicholson

2011

annals

103

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Laparoscopic surgery has become the gold standard for many operative procedures in the last 20 years. Its advantages over open surgery are well documented; however, the drive to reduce the trauma of surgical access persists. Laparoscopic techniques utilising only one umbilical port may represent the next step in this surgical evolution. They have been given a myriad of names (single-port access surgery (SPA), one-port umbilical surgery (OPUS), transumbilical endoscopic surgery (TUES) etc) since their inception, with no standardised acronym to date. 1 Single incision laparoscopic surgery (SILS) is an umbrella term used in this article to encompass all such single incision laparoscopic techniques, which allow potentially 'scarless' surgery as the wound is hidden within the umbilicus. Many groups have reported on the feasibility of the technique and its initial success but there have been very few significant trials. There is still no consensus and this field therefore represents a major focus for research and development. A MEDLINE ® search using multiple Medical Subject Headings (MeSH) terms pertaining to this topic highlighted 464 relevant articles in the literature. This article aims to present the current possibilities offered by this technique within general surgery and the evidence supporting it. DiscussionThere is still much debate over whether SILS is the future of laparoscopic surgery or just a passing fad. SILS was first described in general surgery in 1997 to perform laparoscopic cholecystectomies 1,2 and appendicectomies 1,3 but enthusiasm was limited because of poor equipment and technical support. In 2005 a resurgence was initiated in urology by Hirano et al. 4 Technical improvements that enabled this revival included bent or articulating instruments, adjustments in laparoscopes, several adjacently placed trocars through one incision and special multilumen ports that allow simultaneous multiple instrument insertion. 1 Many of the big healthcare manufacturers have seen this emerging market and new operative hardware is being developed to facilitate the technique. Devices like the TriPort (Advanced Surgical Concepts, Wicklow, Ireland) (Fig 1), the AirSeal ® (SurgiQuest Inc, Orange, CT, US) (Fig 3) and the SILS ™ port (Covidien, Norwalk, CT, US) have made single site surgery easier and more efficient. A return to SILS cholecystectomies followed and this is the most studied general surgery procedure using the technique. However, the repertoire of operations amenable to SILS is expanding and recently published papers describe SILS approaches for totally extraperitoneal inguinal hernia repair, 6 Single incision laparoscopic surgery (SILS) is a rapidly developing field that may represent the future of laparoscopic surgery. The major advantage of SILS over standard laparoscopic surgery is in cosmesis, with surgery becoming essentially scarless if the incision is hidden within the umbilicus. Only one incision is required so the risk of potential complications like port site hernias, haematomas and wound in...

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Single-incision laparoscopic appendectomy for acute appendicitis: a preliminary experience

Cited by 51 publications

References 30 publications

Technical approaches to single port/incision laparoscopic appendicectomy: a literature review

Technical approaches to single port/incision laparoscopic appendicectomy: a literature review

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

Single incision laparoscopic surgery in general surgery: a review

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