Single-incision laparoscopic surgery versus conventional laparoscopic appendectomy

Jawahar K.; Sharanya R.; Sanjay Prakash

doi:10.18203/2349-2902.isj20184645

Authors

Jawahar K. Department of General Surgery, Saveetha Medical College Hospital, Thandalam, Tamil Nadu, India
Sharanya R. Department of General Surgery, Saveetha Medical College Hospital, Thandalam, Tamil Nadu, India
Sanjay Prakash Department of General Surgery, Saveetha Medical College Hospital, Thandalam, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20184645

Keywords:

Laparoscopic appendicectomy, Operative time, Patient satisfaction, SILS

Abstract

Background: Single Incision Laparoscopic Surgery (SILS) is a new technique of minimally invasive surgery using a single incision to minimize all ports to one site, hence a single scar that can be strategically placed in the umbilicus for a perceived scar less abdomen.

Methods: We report this study evaluating the possible advantages of SILS versus conventional laparoscopic appendectomy through a randomized controlled trial. The study population includes patients diagnosed as acute appendicitis. A total of 50 patients underwent appendectomy, patients were randomly assigned to either SILS appendectomy or conventional appendectomy in 1:1 ratio. Primary end points were operative time, complication rate, postoperative pain, post-operative hospital stay and patient satisfaction.

Results: The pain scores measured at 48 hours were significantly lower in SILS group than conventional Lap appendectomy group. Patients had significant satisfaction score and lower pain score in SILS group than Lap appendectomy group measured at 6 weeks after appendectomy. However, the post-operative stay was similar in both the groups. There was no conversion to open appendectomy in both the groups. Patient satisfaction score in SILA was found to be higher than CLA. Operating times were similar and post-operative stay was apparently lower.

Conclusions: SIL appendectomy is as safe and effective as conventional lap appendectomy.

Metrics

Metrics Loading ...

References

Palanivelu C, Rajan PS, Rangarajan M, Parthasarathi R, Senthilnathan P, Praveenraj P. Transumbilical flexible endoscopic cholecystectomy in humans: first feasibility study using a hybrid technique. Endoscop. 2008;40(5):428-31.

Pelosi MA, Pelosi MA. Laparoscopic appendectomy using a single umbilical puncture (mini laparoscopy). J Reprod Med Obstet Gynaecol. 1992;37(7):588-94.

Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, European Palliative Care Research Collaborative (EPCRC), et al. Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Management. 2011;41(6):1073-93.

Kozma CM, Slaton TL, Monz BU, Hodder R, Reese PR. Development and validation of a patient satisfaction and preference questionnaire for inhalation devices. Treatments Resp Med. 2005;4(1):41-52.

Pelosi MA, Pelosi MA III. Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med. 1992;37:588-94.

Hong TH, Kim HL, Lee YS. Transumbilical single-port laparoscopic appendectomy (TUSPLA): scarless intracorporeal appendectomy. J Laparoendosc Adv Surg Tech A. 2009;19:75-8.

Oltmann SC, Garcia NM, Ventura B. Single-incision laparoscopic surgery: feasibility for pediatric appendectomies. J Pediatr Surg. 2010;45:1208-12.

Ahmed K, Wang TT, Patel VM. The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review. Surg Endosc. 2011;25:378-96.

Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2004;4:CD001546.

Antoniou SA, Koch OO, Antoniou GA, Lasithiotakis K, Chalkiadakis GE, Pointner R, et al. Meta-analysis of randomized trials on single-incision laparoscopic versus conventional laparoscopic appendectomy. Am J Surg. 2014;207:613-22.

Tate JJT, Dawson JW, Chung SCS, LauWY, Li AKC. Laparoscopic versus open appendectomy: prospective randomised trial. Lancet. 1993;342:633-7.

Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2004;4:CD001546.

Van Dalen R, Bagshaw PF, Dobbs BR, Robertson GM, Lynch AC, Frizelle FA. The utility of laparoscopy in the diagnosis of acute appendicitis in women of reproductive age: a prospective randomized controlled trial with long-term follow-up. Surg Endosc. 2003;17:1311-3.

Hellberg A, Rudberg C, Enochsson L, Gudbjartson T, Wenner J, Kullman E, et al. Conversion from laparoscopic to open appendectomy: a possible drawback of the laparoscopic technique? Eur J Surg. 2001;167:209-13.