Single-Port Transumbilical Laparoscopic Appendectomy: A Preliminary Multicentric Comparative Study in 87 Patients with Acute Appendicitis

Abstract

Introduction. Laparoscopic appendectomy (LA) has been performed in many approaches such as open, laparoscopic and recently Single Port Access (SPAA). In order to elucidate its potential advantages, we compared the two laparoscopic approaches. Methods. 87 patients were included in a multicentric study for suspected appendicitis in order to perform (SPAA) appendectomy or laparoscopic appendectomy (LA). All outcomes, including blood loss, operative time, complications, and length of stay and pain were recorded prospectively. Results. There were 46 patients in the SPAA group and 41 in the LAG with a mean operative time of 40,4 minutes in the SPAA group and 35,0 minutes in the LA group. Only one patient was converted to an open approach. We described only 2 complications. Pain was graded 2,8 in the SPAA group and 2,9 in the LA group, according to the AVS after 24 hours. Patients in the SPAA Group were more satisfied (7,5 versus 6,9) (P < 0.05). Same results were found for the cosmetic result (8,6 versus 7,4) (P < 0.05). Conclusion. Using the single port approach feasible and safe. The true benefit of the technique should be assessed by new randomised controlled trials.

A comparative study between single incision laparoscopic appendectomy and conventional laparoscopic appendectomy

“…Similar cosmetic results were published by Vilallonga R et al 24 in which mean satisfaction of cosmetic result was better in SILS than CLA and the difference was statistically significant (p<0.05).…”

Can Single Incision Laparoscopic Appendectomy Replace the Traditional Three Port Laparoscopic Approach in Coming Future: A Review

“…A visual analogous scale was used from 0-10 in which 0 refers no pain whereas as 10 refers to severe pain in ascending order. In another study Post-surgery pain was measured using the VAS scale (0-10), with higher readings for SILS with a statistically significant difference, SILA=4, 3PLA=3.3 [23]. In contrary other study by Ahmed et al [25] showed patient have slightly less pain following SILA; comparison to 3-PLA.…”

“…As one study by Adolfo et al [30] showed the mean postoperative hospital stay was shorter in the SILA group than in the 3PLA group but the difference was not significant. Other studies though, didn't find a much significant difference in hospital stay [20,23,31,32]. However some studies regarding SILC was said to have a significantly shorter stay in the hospital [33].…”

“…According to the studies conducted by Teoh [16,18,[20][21][22][23] the results showed that SILA was associated with significant longer operative times than 3-port LA. More time is needed for performing SILA than 3PLA may be due to the characteristic single incision of SILA technique would increase its technical difficulty because all surgical procedures have to be performed in one working channel [18,24].…”

Single Incision versus Conventional Multiport Laparoscopic Appendectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Twelve Potentially appropriate RCTs comparing SILA and CMLA were identified [10,11,12,13,14,15,16,17,18,19,20,21]. Among them, one study that applied a laparoscopic-assisted extracorporeal appendectomy technique was excluded [10].…”