Abstract
Background
Natural orifice translumenal endoscopic surgery (NOTES) is a major conceptual change in the field of modern surgery. However, corresponding technological refinements are not yet available to fill the gap separating the current laparoscopy from the NOTES of the future. Meanwhile, “hybrid” NOTES techniques, including single-port procedures, have been increasingly reported. This report describes a technique of single-incision laparoscopic appendectomy (SILA) for selected patients with acute appendicitis.
Methods
Patients with noncomplicated acute appendicitis, excluding those with abscess, perforation, peritonitis, previous surgery, or obesity, underwent SILA. The procedure was performed using a single 15-mm-diameter umbilical incision with two 5-mm-diameter port sites.
Results
The study enrolled 36 women and 19 men with a mean age of 28 years (range, 18–78 years). The procedure was achieved for 41 patients (74.5%). The mean operative time was 39 min (range, 14–111 min). There was no mortality. The postoperative complication rate was 5.4% (3 complications in 3 patients), and the median hospital stay was 39 h (range, 8–240 h).
Conclusion
The SILA technique is safe and feasible for selected patients with noncomplicated acute appendicitis. Compared with other transumbilical techniques of appendectomy, SILA has the advantages of feasibility without endoscopic skills and an acceptable operative time. Technical refinements and accomplished learning probably will enable its wider use for more patients with acute appendicitis.
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Disclosures
Andrew A. Gumbs is a consultant for Ethicon, a proctor and course instructor for Covidien, and a proctor for Novare Surgical. He has received honoraria from Novare Surgical and Applied Medical. Elie Chouillard, Arnaud Dache, Adriana Torcivia, Nada Helmy, and Ivan Ruseykin have no conflicts of interest or financial ties to disclose.
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Chouillard, E., Dache, A., Torcivia, A. et al. Single-incision laparoscopic appendectomy for acute appendicitis: a preliminary experience. Surg Endosc 24, 1861–1865 (2010). https://doi.org/10.1007/s00464-009-0860-1
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DOI: https://doi.org/10.1007/s00464-009-0860-1