J Korean Surg Soc.  2012 Oct;83(4):212-217. 10.4174/jkss.2012.83.4.212.

Transumbilical single port laparoscopic appendectomy using basic equipment: a comparison with the three ports method

• Lee JS
• Choi YI
• Lim SH
• Hong TH

• KMID: 2212307
• DOI: http://doi.org/10.4174/jkss.2012.83.4.212

Abstract

PURPOSE
Single port laparoscopic surgery is a rapidly evolving laparoscopic surgical approach. We report a comparison of transumbilical single port laparoscopic appendectomy (TUSPLA) and conventional laparoscopic appendectomy (CLA) in a Korean military hospital.
METHODS
This single-center retrospective study of 63 patients who received laparoscopic appendectomy was conducted between May 2011 and October 2011. Nineteen patients received TUSPLA and 44 patients received CLA. Clinical outcomes such as operation time, hospital stay, postoperative pain, diet, and postoperative complication were reviewed.
RESULTS
There were no statistically significant differences between TUSPLA and CLA patients, respectively, in operation time (58.9 minutes vs. 52.3 minutes, P = 0.262), duration of hospitalization (10.2 days vs. 10.6 days, P = 0.782), mean visual analogue scale score (2.6 vs. 2.5, P = 0.894), and return to diet (1.6 days vs. 1.7 days, P = 0.776). There were two cases (10.5%) of short-term complications in the TUSPLA group and four cases (9.1%) of short-term complications in the CLA group. All patients were fully recovered at discharge.
CONCLUSION
TUSPLA is a feasible alternative for CLA. When a glove port is used, no special instruments are needed. Thus, it can be performed in a hospital equipped with basic laparoscopic surgical instruments.

Keyword

Laparoscopy; Appendectomy; Single-port; Transumbilical; Scarless

MeSH Terms

Appendectomy
Diet
Hospitalization
Humans
Laparoscopy
Length of Stay
Military Personnel
Pain, Postoperative
Postoperative Complications
Retrospective Studies
Surgical Instruments

Figure

• 

  Fig. 1 To make the glove port, three 5-mm trocars were attached to the digits of a small surgical glove. After appendectomy, the resected appendix was put inside one of the digits (red arrow).

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  Fig. 2 Comparison of the cosmetic effects of transumbilical single port laparoscopic appendectomy (TUSPLA) and three ports laparoscopic appendectomy (TLA) immediately after surgery. (A) After TUSPLA, the scar is concealed in the umbilicus. (B) After TLA, although a transumbilical incision was used to reduce the umbilical scar, the other two 5-mm incisions were clearly visible.

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  Fig. 3 Decreasing operation time according to surgical experience in transumbilical single port laparoscopic appendectomy group. Red line indicates the mean operation time.

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