Single-incision laparoscopic appendectomy using conventional instruments: an initial experience using a novel technique.

BACKGROUND: Laparoscopic appendectomy has gained wide acceptance. This study aimed to evaluate the feasibility, safety, and cosmetic results of a novel technique: single incision laparoscopic (SIL) appendectomy.

METHODS: The study enrolled consecutive patients undergoing appendectomy for acute appendicitis. Appendectomy was performed using three trocars and conventional laparoscopic instruments through a single small umbilical incision (length, ~3 cm). The patients received standard pre- and postoperative care and presented for a follow-up visit after a mean of 27 days.

RESULTS: The study cohort consisted of 26 patients (10 women and 16 men) with an average age of 44 years (range, 13-83 years). Of 26 appendectomies, 22 (85%) were achieved through a single surgical site. The mean SIL appendectomy operative time was 58 min (range, 33-107 min). No operative complications occurred. The average postoperative hospital stay was 1.2 days for nonperforated appendicitis and 2.7 days for perforated appendicitis. At the follow-up visit, no patient showed any evidence of incisional hernia. The operative incisions were minimally visible, and all the individuals reported a highly favorable cosmetic outcome.

CONCLUSIONS: The results of the study demonstrated that laparoscopic appendectomy can be achieved through a single umbilical incision using conventional instruments and that this approach is successful, safe, and aesthetic.