Laparoscopic transumbilical single-port appendectomy: initial experience and comparison with three-port appendectomy.

PURPOSE

Laparoscopic appendectomy usually needs 3 ports, 1 for the videoscope and 2 as working channels. The aim of this study was to compare the feasibility and postoperative outcomes of laparoscopic transumbilical single-port appendectomy with conventional three-port appendectomy.

METHODS

From October 2008 to January 2009, 35 patients underwent single-port appendectomy (SA). Surgical outcomes such as operation time, number of times of parenteral analgesic injected, complication, and hospital stay of 35 patients receiving SA were analyzed and compared with those of 37 patients receiving three-port appendectomy (TA) during the same period.

RESULTS

Comparing SA with TA, there were no statistically significant differences in operation time (75.9+/-27.4 vs. 66.4+/-21.7 min), times of injected analgesic (0.86+/-1.3 vs. 0.97+/-1.47 times), complication rate (8.6% vs. 2.7%), and hospital stay (3.0+/-1.3 vs. 3.2+/-1.4 d). The most common complication was wound infection (2 cases for SA and 1 for TA). One instance of intra-abdominal fluid accumulation occurred in a patient with perforated appendicitis during SA, and this was managed with image-guided drainage. In contrast to the TA, the abdominal scar in SA was nearly inconspicuous.

CONCLUSIONS

This study showed SA to be feasible, and it did not show any difference in postoperative outcomes compared with TA. Moreover, SA can produce scarless surgery without the need for specialized instrumentation.