Single-port laparoscopy assisted appendectomy under local pneumoperitoneum condition.

We describe herein a novel, simplified technique of laparoscope-assisted appendectomy under local pneumoperitoneum condition. A 12-mm-outer-diameter laparoscope fitted with a transparent plastic cap is inserted through a single, small, open laparotomy incision. This scope has a 5-mm working channel for insertion of the multifunctional metallic catheter which maintains the local pneumoperitoneum condition. When we have located the inflamed appendix by tracing the tenia of cecum, we use the grasping forceps protruding from the working channel of this laparoscope to grasp its tip or root on the cecum. This allows us to pull the appendix up and out through the small incision and to resect it in the conventional surgical way. This procedure permits the surgeon to perform appendectomy by making only one small incision under spinal anesthesia, and also eliminates development of the intracavitary concomitant diseases.