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01-03-2014 | How-I-Do-It Article

Simple technique for gasless transumbilical single-incisional laparoscopic-assisted appendectomy

Authors: Naoya Ikeda, Masato Ueno, Tetsuhiro Kanamura, Masayuki Sho, Yoshiyuki Sasaki, Koji Enomoto, Tomohiro Kunishige, Kazutaka Nogi, Takaaki Kosugi, Kenji Nakagawa, Hiroshi Sakaguchi, Shoko Hidaka, Tomoko Ochi, Yoshiyuki Nakajima

Published in: Langenbeck's Archives of Surgery | Issue 3/2014

Abstract

Purpose

Single-incision laparoscopic surgery has recently received more attention. We developed a novel simple technique of gasless transumbilical single-incisional laparoscopic-assisted appendectomy (TUSILAA) and retrospectively analyzed our initial experience.

Methods

TUSILAA has been attempted in 50 consecutive patients with acute appendicitis. The vertical incision through the umbilicus was used for laparoscopic access and the abdominal wall was lifted by a Kent retractor set system.

Results

Our technique was successful in 45 out of 50 (90 %) patients. The median operating time was 59 min (range 35–140). The median length of postoperative hospital stay was 4 days (range 2–12). None of the cases were converted to open appendectomy. There were no perioperative surgical complications.

Conclusions

Our novel technique, gasless TUSILAA, is safe and feasible with acceptable operative time and excellent cosmetic result. Furthermore, this procedure has the advantage of cost-effectiveness since any disposable instruments including trocars, staplers, or expensive devices are not required. Therefore, this could be used as the first-choice surgical procedure for selected patients with uncomplicated acute appendicitis.

Semm K (1983) Endoscopic appendectomy. Endoscopy 15(2):59–64. doi:10.1055/s-2007-1021466 PubMedCrossRef

Sauerland S, Lefering R, Neugebauer EA (2004) Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 4, CD001546. doi:10.1002/14651858.CD001546.pub2 PubMed

Ortega AE, Hunter JG, Peters JH, Swanstrom LL, Schirmer B (1995) A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Laparoscopic Appendectomy Study Group. Am J Surg 169(2):208–212, discussion 212–203PubMedCrossRef

Ignacio RC, Burke R, Spencer D, Bissell C, Dorsainvil C, Lucha PA (2004) Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial. Surg Endosc 18(2):334–337. doi:10.1007/s00464-003-8927-x PubMedCrossRef

Aziz O, Athanasiou T, Tekkis PP, Purkayastha S, Haddow J, Malinovski V, Paraskeva P, Darzi A (2006) Laparoscopic versus open appendectomy in children: a meta-analysis. Ann Surg 243(1):17–27PubMedCentralPubMedCrossRef

Pelosi MA, Pelosi MA 3rd (1992) Laparoscopic appendectomy using a single umbilical puncture (minilaparoscopy). J Reprod Med 37(7):588–594PubMed

Chen D, Shi H, Dong H, Liu K, Ding K (2011) Gasless single-incision laparoscopic appendectomy. Surg Endosc 25(5):1472–1476. doi:10.1007/s00464-010-1416-0 PubMedCrossRef

Chiu CG, Nguyen NH, Bloom SW (2011) Single-incision laparoscopic appendectomy using conventional instruments: an initial experience using a novel technique. Surg Endosc 25(4):1153–1159. doi:10.1007/s00464-010-1332-3 PubMedCrossRef

Cho MS, Min BS, Hong YK, Lee WJ (2011) Single-site versus conventional laparoscopic appendectomy: comparison of short-term operative outcomes. Surg Endosc 25(1):36–40. doi:10.1007/s00464-010-1124-9 PubMedCrossRef

10.

Ohno Y, Morimura T, Hayashi S (2012) Transumbilical laparoscopically assisted appendectomy in children: the results of a single-port, single-channel procedure. Surg Endosc 26(2):523–527. doi:10.1007/s00464-011-1912-x PubMedCrossRef

11.

St Peter SD, Adibe OO, Juang D, Sharp SW, Garey CL, Laituri CA, Murphy JP, Andrews WS, Sharp RJ, Snyder CL, Holcomb GW 3rd, Ostlie DJ (2011) Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg 254(4):586–590. doi:10.1097/SLA.0b013e31823003b5 PubMedCrossRef

12.

Pedersen AG, Petersen OB, Wara P, Ronning H, Qvist N, Laurberg S (2001) Randomized clinical trial of laparoscopic versus open appendicectomy. Br J Surg 88(2):200–205. doi:10.1046/j.1365-2168.2001.01652.x PubMedCrossRef

13.

Ikeda N, Ueno M, Kanamura T, Kojima Y, Nakagawa K, Ishioka K, Sasaki Y, Sho M, Sakaguchi H, Hidaka S, Ochi T, Nakajima Y (2013) Safety and feasibility for single-incision laparoscopic cholecystectomy in local community hospital: a retrospective comparison with conventional 4-port laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 23(1):33–36. doi:10.1097/SLE.0b013e31827577f8 PubMedCrossRef

14.

Valla J, Ordorica-Flores RM, Steyaert H, Merrot T, Bartels A, Breaud J, Ginier C, Cheli M (1999) Umbilical one-puncture laparoscopic-assisted appendectomy in children. Surg Endosc 13(1):83–85PubMedCrossRef

15.

Esposito C (1998) One-trocar appendectomy in pediatric surgery. Surg Endosc 12(2):177–178PubMedCrossRef

16.

Tsunezuka Y, Oda M, Moriyama H (2006) Wound retraction system for lung resection by video-assisted mini-thoracotomy. Eur J Cardiothorac Surg 29(1):110–111. doi:10.1016/j.ejcts.2005.10.027 PubMedCrossRef

17.

Takeda A, Sakai K, Mitsui T, Nakamura H (2007) Management of large cystic adnexal tumor by gasless laparoscopic-assisted surgery with wound retractor. J Minim Invasive Gynecol 14(5):644–650. doi:10.1016/j.jmig.2007.04.003 PubMedCrossRef

18.

Vettoretto N, Agresta F (2011) A brief review of laparoscopic appendectomy: the issues and the evidence. Tech Coloproctol 15(1):1–6. doi:10.1007/s10151-010-0656-2 PubMedCrossRef

19.

Hirvonen EA, Poikolainen EO, Paakkonen ME, Nuutinen LS (2000) The adverse hemodynamic effects of anesthesia, head-up tilt, and carbon dioxide pneumoperitoneum during laparoscopic cholecystectomy. Surg Endosc 14(3):272–277PubMedCrossRef

20.

Uen YH, Chen Y, Kuo CY, Wen KC, Koay LB (2007) Randomized trial of low-pressure carbon dioxide-elicited pneumoperitoneum versus abdominal wall lifting for laparoscopic cholecystectomy. J Chin Med Assoc 70(8):324–330. doi:10.1016/S1726-4901(08)70013-3 PubMedCrossRef

21.

Jiang JK, Chen WS, Wang SJ, Lin JK (2010) A novel lifting system for minimally accessed surgery: a prospective comparison between “Laparo-V” gasless and CO2 pneumoperitoneum laparoscopic colorectal surgery. Int J Colorectal Dis 25(8):997–1004. doi:10.1007/s00384-010-0942-5 PubMedCrossRef

22.

Escobar PF, Fader AN, Paraiso MF, Kaouk JH, Falcone T (2009) Robotic-assisted laparoendoscopic single-site surgery in gynecology: initial report and technique. J Minim Invasive Gynecol 16(5):589–591. doi:10.1016/j.jmig.2009.05.004 PubMedCrossRef

23.

Romanelli JR, Earle DB (2009) Single-port laparoscopic surgery: an overview. Surg Endosc 23(7):1419–1427. doi:10.1007/s00464-009-0463-x PubMedCrossRef

24.

Rozen WM, Tran TM, Ashton MW, Barrington MJ, Ivanusic JJ, Taylor GI (2008) Refining the course of the thoracolumbar nerves: a new understanding of the innervation of the anterior abdominal wall. Clin Anat 21:325–333. doi:10.1002/ca.20621 PubMedCrossRef

Title: Simple technique for gasless transumbilical single-incisional laparoscopic-assisted appendectomy
Authors: Naoya Ikeda
Masato Ueno
Tetsuhiro Kanamura
Masayuki Sho
Yoshiyuki Sasaki
Koji Enomoto
Tomohiro Kunishige
Kazutaka Nogi
Takaaki Kosugi
Kenji Nakagawa
Hiroshi Sakaguchi
Shoko Hidaka
Tomoko Ochi
Yoshiyuki Nakajima
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 3/2014
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-014-1164-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Simple technique for gasless transumbilical single-incisional laparoscopic-assisted appendectomy

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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