Single-site umbilical laparoscopic appendectomy

Department of Surgery and Center for Prospective Clinical Trials, Children's Mercy Hospital, Kansas City, Missouri 64108, USA.
Seminars in Pediatric Surgery (Impact Factor: 1.94). 11/2011; 20(4):196-200. DOI: 10.1053/j.sempedsurg.2011.05.003
Source: PubMed

ABSTRACT Laparoscopic appendectomy has become the standard approach in most institutions for children with nonperforated appendicitis, and in many institutions for patients with perforated appendicitis. Because of public perception and continued surgical innovation, there has been an impetus to perform operations with fewer and fewer scars, ultimately moving toward "scarless" surgery. Improvements in the laparoscopic technique and instrumentation have led to multiple reports of appendectomy in children being performed by the use of a single-incision approach. Although this approach remains an unproven benefit compared with a traditional laparoscopic appendectomy, the pressures to adopt single-incision appendectomy will continue to increase. This article will review the background of laparoscopy for appendectomy, the introduction of the single-incision approach, available data and outcomes from current literature, and a description of our technique.

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    ABSTRACT: Abstract Background: Single-incision laparoscopic surgery (SILS) developed rapidly in recent years. This report describes our initial experience on SILS combined cholecystectomy and appendectomy (SILSC&A) with a unique method of umbilical reconstruction. In addition, a retrospective comparison with conventional combined laparoscopic cholecystectomy and appendectomy (LC&A) was analyzed. Materials and Methods: Between April 2009 and December 2013, 62 patients with benign gallbladder and appendix disease underwent laparoscopic combined cholecystectomy and appendectomy at our institution. Of these, 34 (54.8%) underwent SILSC&A (Group 1), and 28 (45.2%) underwent LC&A (Group 2). Demographic, intraoperative, and postoperative data were analyzed retrospectively and compared between the two groups. Results: No significant differences were identified in the preoperative patient characteristics between the two groups. SILSC&A was associated with a shorter operative time (62.2±19.7 versus 77.5±21.4 minutes, respectively; P=.005) and better cosmetic results (4.6±0.7 versus 4.1±0.6, respectively; P=.004). There were no significant differences between the two groups with respect to other postoperative variables. Conclusions: The present study suggests that SILSC&A is as safe and efficacious as conventional LC&A in experienced hands. A uniform method of umbilical reconstruction is helpful in improving cosmesis and decreasing hernia rate. Long-term follow-up and further prospective randomized trials are anticipated.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 09/2014; 24(10). DOI:10.1089/lap.2014.0182 · 1.19 Impact Factor
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    Pediatric Transplantation 12/2013; 18(2). DOI:10.1111/petr.12212 · 1.63 Impact Factor