Yanan Wang1, Wenjun Xiong2, Xiaoliang Lan1, Jianming Zhang1, Tao Chen1, Hao Liu1, Guoxin Li3. 1. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. 2. Guangdong Province Hospital of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China. 3. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address: gzliguoxin@163.com.
Abstract
BACKGROUND: The single incision method through the umbilicus is commonly used for laparoscopic appendectomy. To obtain a better cosmetic outcome and less surgical complexity, we have designed a new single-incision laparoscopic appendectomy technique performed above the pubic symphysis. METHODS: Between January 2011 and January 2012, patients with uncomplicated acute or chronic appendicitis, excluding those with abscess, perforation, peritonitis, and previous pelvic surgery, underwent this innovative laparoscopic appendectomy. During each operation, a multichannel trocar composed of a small wound protector and a size 6 sterile glove was deployed after a 2 cm transverse incision was made 1-2 cm above the pubic hair area. RESULTS: Of the 42 patients, 24 were male and 18 were female. Their mean age was 30 ± 11 y. The mean operative time was 58 ± 11 min, mean time to first flatus postoperatively was 17 ± 8 h, and mean postoperative length of hospital stay was 3 ± 1 d. No complications occurred during surgery. No patient required conversion to either multiport or open appendectomy. Postoperative wound inflammation was observed in one case (2.3%). CONCLUSIONS: Our results suggested that suprapubic single-incision laparoscopic appendectomy seems to be safe and feasible for selected patients, in consideration of cosmetic outcomes.
BACKGROUND: The single incision method through the umbilicus is commonly used for laparoscopic appendectomy. To obtain a better cosmetic outcome and less surgical complexity, we have designed a new single-incision laparoscopic appendectomy technique performed above the pubic symphysis. METHODS: Between January 2011 and January 2012, patients with uncomplicated acute or chronic appendicitis, excluding those with abscess, perforation, peritonitis, and previous pelvic surgery, underwent this innovative laparoscopic appendectomy. During each operation, a multichannel trocar composed of a small wound protector and a size 6 sterile glove was deployed after a 2 cm transverse incision was made 1-2 cm above the pubic hair area. RESULTS: Of the 42 patients, 24 were male and 18 were female. Their mean age was 30 ± 11 y. The mean operative time was 58 ± 11 min, mean time to first flatus postoperatively was 17 ± 8 h, and mean postoperative length of hospital stay was 3 ± 1 d. No complications occurred during surgery. No patient required conversion to either multiport or open appendectomy. Postoperative wound inflammation was observed in one case (2.3%). CONCLUSIONS: Our results suggested that suprapubic single-incision laparoscopic appendectomy seems to be safe and feasible for selected patients, in consideration of cosmetic outcomes.