DOI: http://dx.doi.org/10.18203/2349-2902.isj20212341

Comparison of the surgical and post-operative outcomes between single incision laparoscopic appendicectomy (cross triangulation method) with normal conventional laparoscopic appendicectomy

Pratheep Samraj Rajendran Paulraj, Kiran Kailas Chirayil, Renuka Jayakumar Bellasindhi, Punitha Thetraravu Oli, Mohith Mathew, Anish Jomy

Abstract


Background: The usual multiport conventional laparoscopic surgeries (appendicectomy) are now being replaced by single incision laparoscopic surgeries (appendicectomy).In our study various aspects of SILS in comparison with the multiport conventional laparoscopic appendicectomy such as incision site pain, duration of surgery, morbidity and instruments used are discussed, duration of surgery, morbidity and instruments used are discussed.

Methods: A single blinded randomized control trial was done on patients presenting with acute appendicitis. Pain numerical scale, use of analgesics, time to return to routine activities, hospital re-admission, complication like port site infection, hernia, intra operative complications rates, conversion rates and duration of surgery were evaluated. Various statistics of pain and other parameters are studied and evaluated. The mean operation time, mean recovery time, post-operative pain were statistically analysed using unpaired t-test.

Results: Mean operating time was 44.16 minutes for SILS and 26.88 minutes for laparoscopic appendicectomy. The mean operative pain in scale of 1 to 4 was 1.40 and 0.40 for SILS and for laparoscopic appendicenctomy respectively making SILS more pain free and comfortable for the patient. The mean post-operative recovery time was 3.12 days for SILS and 7.88 days for laparoscopic appendicenctomy giving SILS patients more rapid recovery and resumption of work.  

Conclusions: SILS offers better cosmetic outcome, lesser post-operative pain and shorter duration of hospital stay compared to classical 3 port conventional laparoscopic surgery but at the expense of time. Operative difficulties along with time constraint need to be overcome by the surgeon.


Keywords


Single incision laparoscopic appendicectomy, Conventional laparoscopic appendicectomy, Multiport laparoscopic appendectomy

Full Text:

PDF

References


Eng MK, Langebrekke A, Hudelist G. Complications in operative hysteroscopy - is prevention possible? Acta Obstet Gynecol Scand. 2017;96(12):1399-403.

Hindery R. UCSF Surgeons Perform First Single-Incision Gallbladder Removal, 2009. Available at: https://www.ucsf.edu/news/2009/06/2953/ucsfperforms-san-franciscos-first-single-incision-gallbladder-removal. Accessed on 09 May 2021.

Rehman H, Fitzgerald JE, Frantzias J, Lemon J, Ahmed I. The need for training frameworks and scientific evidence in developing scarless surgery: a national survey of surgeons' opinions on single port laparoscopic surgery. Int J Surg. 2013;11(1):73-6.

Nguyen NT, Hinojosa MW, Smith BR, Reavis KM. Single laparoscopic incision transabdominal (SLIT) surgery-adjustable gastric banding: a novel minimally invasive surgical approach. Obes Surg. 2008;18(12):1628-31.

Ateş 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(6):1071-4.

Zhou H, Jin K, Zhang J, Wang W, Sun Y, Ruan C, et al. Single incision versus conventional multiport laparoscopic appendectomy: a systematic review and meta-analysis of randomized controlled trials. Dig Surg. 2014;31(4):384-91.

Ohtani H, Tamamori Y, Arimoto Y, Nishiguchi Y, Maeda K, Hirakawa K. Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis. J Gastrointest Surg. 2010;16(10):1929-39.

Jawahar K, Sharanya R, Prakash S. Single-incision laparoscopic surgery versus conventional laparoscopic appendectomy. Int Surg J. 2018;5:3685-9.

Vettoretto N, Mandala V. Single port laparoscopic appendectomy: are we pursuing real advantages? World J Emerg Surg. 2011;6:25.

Liao YT, Lin TH, Lee PC, Chou TH, Liang JT, Lin MT. Learning curve of single-port laparoscopic appendectomy for noncomplicated acute appendicitis: a preliminary analysis compared with conventional laparoscopic appendectomy. J Laparoendosc Adv Surg Tech A. 2013;23(5):441-6.