An observational study to compare single incision laparoscopic appendectomy with conventional multiport laparoscopic appendectomy


  • Manoj Kumar D. Ahire Department of Surgery, Lokmanya Tilak Medical College, Sion, Mumbai, Maharashtra, India
  • Rajiv Karvande Department of Surgery, Lokmanya Tilak Medical College, Sion, Mumbai,Maharashtra,India
  • Machchhindranath V. Nilange Department of Surgery, Lokmanya Tilak Medical College, Sion, Mumbai,Maharashtra,India
  • Chetan M. Rathod Department of Surgery, Lokmanya Tilak Medical College, Sion, Mumbai,Maharashtra,India



Single incision, SILS, Multiport laparoscopy, Appendectomy


Background: Appendicitis is the most common intra-abdominal condition requiring emergency surgery and it is approached by laparoscopic procedures. Innovative methods were developed that reduce tissue trauma and offer improved cosmetic results, one of such being the single-incision laparoscopic surgery (SILS) with advantages of reduced postoperative morbidity and almost invisible scar.

Methods: 60 patients were included in the study after meeting inclusion criteria and divided into two groups 30 each. One group had undergone single incision laparoscopic appendectomy and other with multiple port laparoscopic appendectomy. Preoperative, intraoperative and postoperative parameters were collected. Data involving patients’ demographics, operative time, length of hospital stay and both intraoperative and postoperative complications were collected.

Results: The mean duration of surgery in multiple appendectomy was lesser compared to single port appendectomy and values are insignificant (p =0.1844) when compared between the two groups. None of the patients in both the groups did not have any intraoperative complication. Only one patient in single port appendectomy converted to open surgery. The mean postoperative pain VAS score was 2.00 in multiport appendectomy group which was significantly more as compared to 1.60 among single port appendectomy group after 24 hrs. The postoperative complications and the duration of stay in hospital were almost similar in both the groups. The complications observed during follow up in both the cases were minimal and statistically insignificant.

Conclusions: The major advantage of SILS is cosmetic satisfaction, while the disadvantages of SILS are longer operative time and higher conversion rate.


Bresciani C, Perez RO, Habr-Gama A, Jacob CE, Ozaki A, Batagello C, et al. Laparoscopic versus standard appendectomy outcomes and cost comparisons in the private sector. J Gastrointest Surg. 2005;9:1174-82.

Martin LC, Puente I, Sosa JL, Bassin A, Breslaw R, McKenney MG, et al. Open versus laparoscopic appendectomy. A prospective randomized comparison. Ann Surg. 1995;222:256-62.

Milewczyk M, Michalik M, Ciesielski M. A prospective, randomized, unicenter study comparing laparoscopic and open treatments of acute appendicitis. Surg Endosc. 2003;17:1023-8.

Sauerland S, Jaschinski T, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2010;10 CD001546.

Vidal O, Ginestà C, Valentini M, Martí J, Benarroch G, García-Valdecasas JC. Suprapubic single-incision laparoscopic appendectomy: a nonvisible-scar surgical option. Surg Endosc. 2011;25:1019–23.

Rothenberg SS, Shipman K, Yoder S. Experience with modified single-port laparoscopic procedures in children. J Laparoendosc Adv Surg Tech. 2009;19:695–8.

Ponsky TA, Diluciano J, Chwals W, Parry R, Boulanger S. Early experience with single-port laparoscopic surgery in children. J Laparoendosc Adv Surg Tech. 2009;19:551–3.

Saber AA, Meslemani AM, Davis R, Pimentel R. Safety zones for anterior abdominal wall entry during laparoscopy: a CT scan mapping of epigastric vessels. Ann Surg. 2004;239:182–5.

Barry M, Winter DC. Laparoscopic port site hernias: any port in a storm or a storm in any port? Ann Surg. 2008;248:687–9.

Petnehazy T, Saxena A, Ainoedhofer H, Hoellwarth ME, Schalamon J. Single-port appendectomy in obese children: an optimal alternative? Acta Paediatr. 2010;99:1370–3.

Canes D, Desai MM, Aron M, Haber GP, Goel RK, Stein RJ, et al. Transumbilical single-port surgery: evolution and current status. Eur Urol. 2008;54:1020–9.

Chow A, Purkayastha S, Nehme J, Darzi LA, Paraskeva P. Single incision laparoscopic surgery for appendicectomy: a retrospective comparative analysis. PubMed. 2010;24:2567-74.

Chow A, Purkayastha S, Paraskeva P. Appendicectomy and cholecystectomy using single-incision laparoscopic surgery (SILS): the first UK experience. PubMed 2009;16:211-7.

Chow A, Aziz O, Purkayastha S, Darzi A, Paraskeva P. Single incision laparoscopic surgery for acute appendicitis: feasibility in pediatric patients. PubMed. 2010:294958. Epub

Vidal O, Ginesta C, Valentini M, Marti J, Benarroch G, Garcia-Valdecasas JC. Suprapubic single-incision laparoscopic appendectomy: a nonvisible-scar surgical option. PubMed. PMID: 20737172.

Sabera AA, Elgamalb MH, El-Ghazalyb TH, Dewoolkarb AV, Aklb A. Simple technique for single incision transumbilical laparoscopic appendectomy. PubMed. 2010:01.

Chouillard E, Dache A, Torcivia A, Helmy N, Ruseykin I, Gumbs A. Single-incision laparoscopic appendectomy for acute appendicitis: a preliminary experience. Epub. 2010;24(8):1861-5.

Kim HJ, Lee JI, Lee YS, Lee IK, Park JH, Lee SK, et al. Single-port transumbilical laparoscopic appendectomy: 43 consecutive cases. Epub. 2010;24(11):2765-9.

Frutos MD, Abrisqueta J, Lujan J, Abellan I, Parrilla P. Randomized prospective study to compare laparoscopic appendectomy versus umbilical single-incision appendectomy. Annals of surgery. 2013;257(3):413-8.






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