N Sato1, M Kojika, Y Yaegashi, Y Suzuki, M Kitamura, S Endo, K Saito. 1. Department of Critical Care Medicine, Iwate Medical University, School of Medicine, 19-1 Uchimaru, Morioka 020-8505, Japan. satonobu@iwate-med.ac.jp
Abstract
BACKGROUND: Do conventional laparoscopic appendectomy (LA) techniques provide truly satisfying results for patients and surgeons? We have devised a more advanced technique that improves cosmesis. METHODS: A 2-mm scope is inserted at the umbilicus, and a 12-mm working trocar is inserted through a suprapubic incision placed below the line of pubic hair. A needle loop retractor (NLR) is inserted to hold the appendix in the lower right abdomen. In this NLR, a stainless steel wire is placed within a needle having a diameter of 2 mm. From the suprapubic trocar, a bipolar coagulator is inserted to transect the appendiceal mesentery. A series of 30 patients underwent this procedure. RESULTS: There were no conversions to laparotomy and no intra- or postoperative complications. CONCLUSIONS: Laparoscopic appendectomy using a 2-mm scope, suprapubic trocar, and an NLR yields optimal cosmetic results. For surgeons, the NLR allows the appendix to be held more firmly than then a 5- or 2-mm grasping forceps is used.
BACKGROUND: Do conventional laparoscopic appendectomy (LA) techniques provide truly satisfying results for patients and surgeons? We have devised a more advanced technique that improves cosmesis. METHODS: A 2-mm scope is inserted at the umbilicus, and a 12-mm working trocar is inserted through a suprapubic incision placed below the line of pubic hair. A needle loop retractor (NLR) is inserted to hold the appendix in the lower right abdomen. In this NLR, a stainless steel wire is placed within a needle having a diameter of 2 mm. From the suprapubic trocar, a bipolar coagulator is inserted to transect the appendiceal mesentery. A series of 30 patients underwent this procedure. RESULTS: There were no conversions to laparotomy and no intra- or postoperative complications. CONCLUSIONS: Laparoscopic appendectomy using a 2-mm scope, suprapubic trocar, and an NLR yields optimal cosmetic results. For surgeons, the NLR allows the appendix to be held more firmly than then a 5- or 2-mm grasping forceps is used.
Authors: B D Matthews; G Mostafa; K L Harold; K W Kercher; P R Reardon; B T Heniford Journal: Surg Laparosc Endosc Percutan Tech Date: 2001-12 Impact factor: 1.719
Authors: Thom E Lobe; Lucian Panait; Giovanni Dapri; Peter M Denk; David Pechman; Luca Milone; Stefan Scholz; Bethany J Slater Journal: Surg Endosc Date: 2022-08-19 Impact factor: 3.453