Two-port laparoscopic appendectomy assisted with needle grasper comparison with conventional laparoscopic appendectomy

Abstract

PurposeThe 2-port laparoscopic appendectomy technique (TLA) is between the conventional 3-port and single-port laparoscopic appendectomy surgeries. We compared postoperative pain and cosmetic results after TLA with conventional laparoscopic appendectomy (CLA) by a 3-port device.MethodsPatients undergoing TLA were matched with patients undergoing CLA between February 2015 and November 2015 at the same institution. Thirty-two patients underwent TLA with a needle grasper. The appendix was secured by a percutaneous organ-holding device (needle grasper), then removed through a puncture at McBurney's point. Another 38 patients underwent CLA. Patient demographics, operative details, and postoperative outcomes were collected and evaluated.ResultsOne patient in the TLA group developed a wound infection and 1 patient in the CLA group developed a postoperative intra-abdominal abscess and 3 wound infections. There was no significant difference between the groups when comparing the length of hospital stay, time until oral intake, and other complications. The pain score in the first 12 hours after surgery was significanly higher in CLA group than the TLA group (P < 0.001). Operative time was significantly shorter in the CLA group compared to the TLA group (P < 0.001).ConclusionTLA using a needle grasper was associated with a significantly lower pain score 12 hours after surgery, better cosmetic results, and lower cost, than the CLA 3-port procedure because of the fewer number of ports.

Conventional laparoscopic appendectomy versus double‐incision, three‐port laparoscopic appendectomy: A 1‐year randomized controlled trial

“…When Donmez et al . introduced a needle grasper device at McBurney's point to hold the appendix, the procedure took 57.03 min . These findings indicate that DILA is comparable and equivalent to CLA in terms of duration of surgery.…”

“…In the first 6 h after surgery in this study, the mean postoperative pain was 6.5 ± 1.4 in the CLA group and 6.4 ± 1.2 in the DILA group; in contrast, Donmez et al . found that the mean postoperative pain was 4.37 in the CLA group and 4.25 in the DILA group . The mean postoperative pain after 24 h was 4.3 ± 1.8 in the CLA group and 4.1 ± 1.9 in the DILA group.…”

“…However, SILS has several limitations: it is difficult to perform, requires a bigger umbilical incision, carries a high risk of port-site incisional hernia, has a longer duration of surgery, and presents a steep learning curve (8,9,13). As a bridge between CLA and SILS, numerous studies have been done in which the number of ports has been reduced; they have also compared CLA and SILS to port exteriorization appendectomy, needlescopic appendectomy, extracorporeal appendectomy, laparoscope-assisted appendectomy, and needle loop retractor appendectomy (6,(14)(15)(16). The present study similarly compared CLA to DILA, but there was no reduction in the number of ports.…”

“…One study had a mean operative time of 35.74 min during extracorporeal ligation of the appendix (6), and another had a mean operative time of 55.7 min when a needle loop retractor was used to retract and manipulate the appendix at McBurney's point (16). When Donmez et al introduced a needle grasper device at McBurney's point to hold the appendix, the procedure took 57.03 min (14). These findings indicate that DILA is comparable and equivalent to CLA in terms of duration of surgery.…”

Laparoskopi̇k Yardimli Mi̇ni̇mal İnvazi̇v Apendektomi̇

“…In the literature, many methods such as classical laparoscopic appendectomy, single port, two ports, Natural Orifice Transluminal Endoscopic Surgery (NOTES) have been described so far. (3)(4)(5)(6). In the present article, we aimed to present the laparoscopy-assisted minimally invasive appendectomy using two 5 mm ports.…”