A comparative study between single incision laparoscopic appendectomy and conventional laparoscopic appendectomy

Mumtaz-ud-Din Wani; Shabir Ahmad Mir; Mohammad Yaqoob; Yawar Watali; Hakim Adil Moheen

doi:10.18203/2349-2902.isj20160222

Authors

Mumtaz-ud-Din Wani Department of Surgery, Government Medical College, Srinagar, India
Shabir Ahmad Mir Department of Surgery, Government Medical College, Srinagar, India
Mohammad Yaqoob Department of Surgery, Apollo Hospital, New Delhi, India
Yawar Watali Department of Surgery, Government Medical College, Srinagar, India
Hakim Adil Moheen BS, University of Kashmir, India

DOI:

https://doi.org/10.18203/2349-2902.isj20160222

Keywords:

Single incision laparoscopic appendectomy, Conventional laparoscopic appendectomy, Acute appendicitis

Abstract

Background: Until recently transumbilical single incision laparoscopic appendectomy has been less popular in clinical practice than traditional laparoscopic appendectomy (LA). The goal of our study was to conduct a comparative analysis of the clinical outcomes for conventional laparoscopic appendectomy (CLA) and transumbilical single incision laparoscopic appendectomy (SILS).

Methods: This prospective study SILS versus CLA was carried out in the postgraduate department of surgery GMC Srinagar from February 2013 to October 2014 on patients suspected of having acute appendicitis. All patients were worked up and assessed according to a predefined protocol-detailed history, complete clinical examination, and laboratory parameters.

Results: The mean age of the patients in the SILS group was 23.9 years (16-35 years) and that in the CLA group was 25.3 years (16-35 years) (p>0.05). The mean operating time in the SILS group was 57.66 minutes and in the CLA group 52.83 minutes (p>0.05). The difference in the postoperative pain score of the two groups was not statistically significant (p>0.05). In our study cosmesis was assessed by using Manchester scar scale. The mean cosmesis scores were: 7^th POD 6.0±0.587 (SILS) and 6.9±0.922 (CLA); 3 months postoperatively 5.73±0.691 (SILS) and 6.56±1.072 (CLA); 6 months postoperatively 5.33±0.606 (SILS) and 6.23±1.104 (CLA). The difference in mean cosmesis score between SILS and CLA was statistically significant (p<0.05).

Conclusions: Our comparative study between single incision laparoscopic appendectomy and conventional laparoscopic appendectomy shows that besides better cosmetic results in the former, there are no added advantages. However, SILS can be a safe and feasible alternative in young females who are cosmesis-conscious.

Metrics

Metrics Loading ...

References

Smink S, Soybel DI. Appendix and appendectomy, in Maingot’s abdominal operation, 11th edition, The MacGraw Hill Companies Inc. USA. 2007;589-612.

Schreiber JH. Early experience with laparoscopic appendectomy in women. Surg Endosc. 1987;1(4):211-6.

Aziz O, Athanasiou T, Tekkis PP, Purkayastha S, Haddow J, Malinoviski V. Laparoscopic versus open appendectomy in children – A meta-analysis. Ann Surg. 2006;243:17-27.

Agresta F, Simone PD, Michelet I, Bedin N. Laparoscopic appendectomy: why it should be done. JSLS. 2003;7:347-52.

Anderson DG, Edelman DS. Laparoscopic appendectomy versus open appendectomy: A single institution study. JSLS. 1997;1:323-4.

Khan MN, Fayyad T, Cecil TD, Moran BJ. Laparoscopic versus open appendectomy: the risk of postoperative infectious complications. JSLS. 2007;11:363-7.

Rispoli G, Armellino MF, Esposito C. One-trocar appendectomy. Surg Endosc. 2002;16:833-5.

Fazili FM, Al-Bouq Y, El-Hassan OM, Gaffar HF. Laparoscope-assisted appendectomy in adults: the two-trocar technique. Ann Saudi Med. 2006;26:100-4.

Panait L, Bell RL, Duffy AJ, Roberts KE. Two-port laparoscopic appendectomy: minimizing the minimally invasive approach. J Surg Res. 2009;153:167-71.

Vidal O, Valentini M. Single incision laparoscopic appendectomy (SILS): Initial experience. Cir Esp. 2009;85:317-9.

Vidal O, Valentini M. Laparoendoscopic single-site surgery appendectomy. Surg Endosc. 2010;24:686-91.

Ng PC. One-puncture laparoscopic appendectomy. Surg Laparosc Endosc. 1997;7:22-4.

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

Pelosi MA, Pelosi MA 3rd. Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med. 1992;37:588-94.

D'Alessio A, Piro E, Tadini B, Beretta F. One-trocar transumbilical laparoscopic-assisted appendectomy in children: our experience. Eur J Pediatr Surg. 2002;12:24-7.

Ates O, Hakguder G, Olguner M, Akgur FM. Single-port laparoscopic appendectomy conducted intracorporeally with the aid of a transabdominal sling suture. J Pediatr Surg. 2007;42:1071-4.

Vidal O, Valentini M, Ginesta C, Marti J, Espert JJ, Benarroch G. Laparoendoscopic single-site surgery appendectomy. Surg Endosc. 2010;24:686-91.

Roberts KE. True single-port appendectomy: first experience with the “puppeteer technique”. Surg Endosc. 2009;23:1825-30.

Lee JS, Choi Y, Lim SH, Hong TH. Transumbilical single port laparoscopic appendectomy using basic equipment; a comparison with the three ports method. J Korean Surg Soc. 2012;83:212-7.

Park JH, Hyun KH, Park CH, Choi SY, Choi WH, Kim DJ. Laparoscopic versus Transumbilical single-Port Laparoscopic Appendectomy: Results of Prospective Randomized Trial. J Korean Surg Soc. 2010;78:213-8.

Kang DB, Lee SH, Lee SY, Oh JT, Park DE, Lee C. Application of single incision laparoscopic surgery for appendectomy in children. J Korean Surg Soc. 2012;82:110-5.

Demirbas S, Atay V, Api A, Erenoglu C, Yildiz M. Laparoscopic appendectomy enables military personnel return to work early. The Internet Journal of Surgery. 2006;9,(2).

Beausang E, Floyd H, Dunn KW. A new quantitative scale for clinical scar assessment. Plast Reconstr Surg. 1998;102:1954-61.

Vilallonga R, Barbaros U, Nada A, S¨umer A, Demirel T, Fort J. Single-Port Transumbilical Laparoscopic Appendectomy: A Preliminary Multicentric Comparative Study in 87 Patients with Acute Appendicitis. Minimally Invasive Surgery 2012.