Simple technique for gasless transumbilical single-incisional laparoscopic-assisted appendectomy

Langenbecks Arch Surg. 2014 Mar;399(3):359-66. doi: 10.1007/s00423-014-1164-z. Epub 2014 Jan 22.

Abstract

Purpose: Single-incision laparoscopic surgery has recently received more attention. We developed a novel simple technique of gasless transumbilical single-incisional laparoscopic-assisted appendectomy (TUSILAA) and retrospectively analyzed our initial experience.

Methods: TUSILAA has been attempted in 50 consecutive patients with acute appendicitis. The vertical incision through the umbilicus was used for laparoscopic access and the abdominal wall was lifted by a Kent retractor set system.

Results: Our technique was successful in 45 out of 50 (90 %) patients. The median operating time was 59 min (range 35-140). The median length of postoperative hospital stay was 4 days (range 2-12). None of the cases were converted to open appendectomy. There were no perioperative surgical complications.

Conclusions: Our novel technique, gasless TUSILAA, is safe and feasible with acceptable operative time and excellent cosmetic result. Furthermore, this procedure has the advantage of cost-effectiveness since any disposable instruments including trocars, staplers, or expensive devices are not required. Therefore, this could be used as the first-choice surgical procedure for selected patients with uncomplicated acute appendicitis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Appendectomy / instrumentation
  • Appendectomy / methods*
  • Appendicitis / surgery*
  • Child
  • Female
  • Humans
  • Laparoscopy / instrumentation
  • Laparoscopy / methods*
  • Length of Stay
  • Male
  • Middle Aged
  • Operative Time
  • Retrospective Studies
  • Treatment Outcome
  • Umbilicus / surgery*
  • Young Adult