Trans-umbilical Single Port Laparoscopic Appendectomy: Initial Experience

Han, Jeong Hee; Ryu, Byoung Yoon; Kim, Hong Ki

Abstract

PURPOSE
Laparoscopic appendectomy is one of the most commonly performed minimally invasive surgeries worldwide. In recent years, successful attempts to reduce the number of conventionally-used three ports have been reported. Specifically, two-port techniques, hybrid approaches and single-port assisted techniques have been described. In this article, we report on the feasibility, safety and cosmesis of trans-umbilical single port laparoscopic appendectomy.
METHODS
The procedure was performed using a single 15-mm-diameter umbilical incision. Under general anesthesia, an Alexis O wound retractor (Applied medical resources Co., Ltd., rancho Santa Margarita) was inserted through the umbilicus. After the appendix and meso-appendix were dissected with a Harmonic scalpel (Ethicon Endo-Surgery, Inc., USA), the base of the appendix was ligated with two Endo-loops (SEOJONG medical Co., Ltd., Korea). The appendix was withdrawn into the wound protector and removed from the abdominal cavity.
RESULTS
This retrospective study enrolled 70 patients (36 females and 34 males with a mean age of 29.0+/-15.0 years). The mean operative time was 49.0+/-13.9 min. There was no mortality. There were five complications in five patients (7.1%) and the median hospital stay was 3.5+/-1.4 days.
CONCLUSION
This is a safe, minimally invasive procedure with excellent cosmetic results. Compared with other trans-umbilical appendectomy techniques, single port laparoscopic appendectomy has the advantages of feasibility without extensive endoscopic skills and an acceptable operative time. Technical refinements and accumulated experience probably will enable its wider use for more patients with acute appendicitis.