PURPOSE: This study evaluated the safety and feasibility of gasless laparoscopic assisted transumbilical appendectomy (GLATUA). METHODS: Data for 62 GLATUA and 84 laparoscopic appendectomies (LA) for uncomplicated appendicitis, which had been performed over a 12 month period in a single institution, were compared retrospectively. The GLATUAs were carried out through an umbilical incision. The abdominal wall was retracted upward using an "L"-shaped retractor and the inflamed appendix was found by gasless laparoscopic vision. A transumbilical extracorporeal appendectomy was then performed. The LAs were performed using a three-port system. RESULTS: The GLATUA group had a shorter mean operative time (44.1+/-22.1 vs. 51.5+/-24.7 min, p=0.06), mean time for resuming a soft diet (29.0+/-9.2 vs. 41.3+/-20.7 hrs, p<0.01) and hospital stay (3.0+/-0.9 vs. 3.6+/-1.7, p<0.01) than the LA group. There was no significant difference in complication rates (6.5% vs. 3.6%, p=0.44). The mean medical costs of the GLATUA group were 66.7% of the LA group. CONCLUSION: GLATUA is a safe, feasible and more cost-effective alternative technique for surgery in uncomplicated acute appendicitis than LA.