J Korean Surg Soc.  2013 Aug;85(2):68-74. 10.4174/jkss.2013.85.2.68.

A comparison of transumbilical single-port laparoscopic appendectomy and conventional three-port laparoscopic appendectomy: from the diagnosis to the hospital cost

• Baik SM
• Hong KS
• Kim YI

• KMID: 2212519
• DOI: http://doi.org/10.4174/jkss.2013.85.2.68

Abstract

PURPOSE
Recently many cases of appendectomy have been conducted by single-incision laparoscopic technique. The aim of this study is to figure out the benefits of transumbilical single-port laparoscopic appendectomy (TULA) compared with conventional three-port laparoscopic appendectomy (CTLA).
METHODS
From 2010 to 2012, 89 patients who were diagnosed as acute appendicitis and then underwent laparoscopic appendectomy a single surgeon were enrolled in this study and with their medical records were reviewed retrospectively. Cases of complicated appendicitis confirmed on imaging tools and patients over 3 points on the American Society of Anesthesia score were excluded.
RESULTS
Among the total of 89 patients, there were 51 patients in the TULA group and 38 patients in the CTLA group. The visual analogue scale (VAS) of postoperative day (POD) #1 was higher in the TULA group than in the CTLA group (P = 0.048). The operative time and other variables had no statistical significances (P > 0.05).
CONCLUSION
Despite the insufficiency of instruments and the difficulty of handling, TULA was not worse in operative time, VAS after POD #2, and the total operative cost than CTLA. And, if there are no disadvantages of TULA, TULA may be suitable in substituting three-port laparoscopic surgery and could be considered as one field of natural orifice transluminal endoscopic surgery with the improvement and development of the instruments and revised studies.

Keyword

Laparoscopic appendectomy; Single incision

MeSH Terms

Anesthesia
Appendectomy
Appendicitis
Handling (Psychology)
Hospital Costs
Humans
Laparoscopy
Medical Records
Natural Orifice Endoscopic Surgery
Operative Time
Retrospective Studies

Figure

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  Fig. 1 Transumbilical incision. The umbilicus was retracted with the towel clips for a full exposure.

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  Fig. 2 A wound retractor was used to prevent from the wound contamination and to secure the space for equipment movement.

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  Fig. 3 Applied equipment for the single port. Three holes were made on the fingers of the surgical glove for the fixation of the 3 trocars. The remained finger parts of the glove were used to place the resected appendix.

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  Fig. 4 The umbilical wound of transumbilical laparoscopic appendectomy, pictured at the operation room just after the surgery.

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