Skip to main content
Top
Published in: World Journal of Emergency Surgery 1/2011

Open Access 01-12-2011 | Review

Single port laparoscopic appendectomy: are we pursuing real advantages?

Authors: Nereo Vettoretto, Vincenzo Mandalà

Published in: World Journal of Emergency Surgery | Issue 1/2011

Login to get access

Abstract

Single port appendectomy, due to its cosmetic appeal and to a technique similar to classic laparoscopic appendectomy, is provoking an increasing number of publications and case series to explore its feasibility and effective improvements for patients with acute appendicitis. The margins for improvement are not so large, as laparoscopic appendectomy is, after 20 years from its beginning, still debated. A literature search has been accomplished to investigate the outcomes of the operation. 23 case series or retrospective comparisons with classic laparoscopy have been found. The numbers and low quality of the published data do not permit to draw evidence based conclusions. Still, trends seem to evidence an increase in complications especially in complicated appendicitis, which suggests caution in its dissemination outside clinical trials.
Literature
1.
go back to reference Vettoretto N, Arezzo A: Human natural orifice translumenal endoscopic surgery: on the way to two different philosophies?. Surg Endosc. 2010, 24 (2): 490-2. 10.1007/s00464-009-0600-6.CrossRefPubMed Vettoretto N, Arezzo A: Human natural orifice translumenal endoscopic surgery: on the way to two different philosophies?. Surg Endosc. 2010, 24 (2): 490-2. 10.1007/s00464-009-0600-6.CrossRefPubMed
2.
go back to reference Bhatia P, Sabharwal V, Kalhan S, John S, Deed JS, Khetan M: Single-incision multi-port laparoscopic appendectomy: how I do it. J Minim Access Surg. 2001, 7 (1): 28-32. Bhatia P, Sabharwal V, Kalhan S, John S, Deed JS, Khetan M: Single-incision multi-port laparoscopic appendectomy: how I do it. J Minim Access Surg. 2001, 7 (1): 28-32.
3.
go back to reference Korndorffer JR, Fellinger E, Reed W: SAGES guideline for laparoscopic appendectomy. Surg Endosc. 2009, 24 (4): 757-61.CrossRefPubMed Korndorffer JR, Fellinger E, Reed W: SAGES guideline for laparoscopic appendectomy. Surg Endosc. 2009, 24 (4): 757-61.CrossRefPubMed
4.
go back to reference Vettoretto N, Gobbi S, Corradi A, Belli F, Piccolo D, Pernazza G, Mannino L, the Italian Association of Hospital Surgeons (Associazione dei Chirurghi Ospedalieri Italiani): Consensus conference on laparoscopic appendectomy: development of guidelines. Colorectal Dis. 2011, 13 (7): 748-54. 10.1111/j.1463-1318.2011.02557.x.CrossRefPubMed Vettoretto N, Gobbi S, Corradi A, Belli F, Piccolo D, Pernazza G, Mannino L, the Italian Association of Hospital Surgeons (Associazione dei Chirurghi Ospedalieri Italiani): Consensus conference on laparoscopic appendectomy: development of guidelines. Colorectal Dis. 2011, 13 (7): 748-54. 10.1111/j.1463-1318.2011.02557.x.CrossRefPubMed
5.
go back to reference Wei B, Qi CL, Chen TF, Zheng ZH, Huang JL, Hu BG, Wei HB: Laparoscopic versus open appendectomy for acute appendicitis: a metaanalysis. Surg Endosc. 2011, 25 (4): 1199-208. 10.1007/s00464-010-1344-z.CrossRefPubMed Wei B, Qi CL, Chen TF, Zheng ZH, Huang JL, Hu BG, Wei HB: Laparoscopic versus open appendectomy for acute appendicitis: a metaanalysis. Surg Endosc. 2011, 25 (4): 1199-208. 10.1007/s00464-010-1344-z.CrossRefPubMed
6.
go back to reference Kapischke M, Friedrich F, Hedderich J, Schulz T, Caliebe A: Laparoscopic versus open appendectomy-quality of life 7 years after surgery. Langenbecks Arch Surg. 2011, 396 (1): 69-75. 10.1007/s00423-010-0715-1.CrossRefPubMed Kapischke M, Friedrich F, Hedderich J, Schulz T, Caliebe A: Laparoscopic versus open appendectomy-quality of life 7 years after surgery. Langenbecks Arch Surg. 2011, 396 (1): 69-75. 10.1007/s00423-010-0715-1.CrossRefPubMed
7.
go back to reference D'Souza N: Appendicitis. Clinical Evidence. 2011, 01: 408-21. D'Souza N: Appendicitis. Clinical Evidence. 2011, 01: 408-21.
8.
go back to reference Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M: The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009, 250 (2): 187-96. 10.1097/SLA.0b013e3181b13ca2.CrossRefPubMed Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M: The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009, 250 (2): 187-96. 10.1097/SLA.0b013e3181b13ca2.CrossRefPubMed
9.
go back to reference Sauerland S, Jaschinski T, Neugebauer EA: Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2010, CD001546-10 Sauerland S, Jaschinski T, Neugebauer EA: Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2010, CD001546-10
10.
go back to reference Kouhia ST, Heiskanen JT, Huttunen R, Ahtola HI, Kiviniemi VV, Hakala T: Long-term follow-up of a randomized clinical trial of open versus laparoscopic appendicectomy. Br J Surg. 2010, 97 (9): 1395-400. 10.1002/bjs.7114.CrossRefPubMed Kouhia ST, Heiskanen JT, Huttunen R, Ahtola HI, Kiviniemi VV, Hakala T: Long-term follow-up of a randomized clinical trial of open versus laparoscopic appendicectomy. Br J Surg. 2010, 97 (9): 1395-400. 10.1002/bjs.7114.CrossRefPubMed
11.
go back to reference Lee SY, Lee HM, Hsieh CS, Chuang JH: Transumbilical laparoscopic appendectomy for acute appendicitis: a reliable one-port procedure. Surg Endosc. 2011, 25 (4): 1115-20. 10.1007/s00464-010-1326-1.CrossRefPubMed Lee SY, Lee HM, Hsieh CS, Chuang JH: Transumbilical laparoscopic appendectomy for acute appendicitis: a reliable one-port procedure. Surg Endosc. 2011, 25 (4): 1115-20. 10.1007/s00464-010-1326-1.CrossRefPubMed
12.
go back to reference Begin GF: Appendicectomie par voie transombilicale vidéo-assistée. J Coelio Chir. 1994, 11: 48-53. Begin GF: Appendicectomie par voie transombilicale vidéo-assistée. J Coelio Chir. 1994, 11: 48-53.
13.
go back to reference Miranda L, Capasso P, Settembre A, Pisaniello D, Marzano LA, Corcione F: Video-assisted appendectomy. Minerva Chir. 2001, 56 (5): 539-42.PubMed Miranda L, Capasso P, Settembre A, Pisaniello D, Marzano LA, Corcione F: Video-assisted appendectomy. Minerva Chir. 2001, 56 (5): 539-42.PubMed
14.
go back to reference Dapri G, Casali L, Bruyns J, Himpens J, Cadiere GB: Single-access laparoscopic surgery using new curved reusable instruments: initial hundred patients. Surg Technol Int. 2010, 20: 21-35.PubMed Dapri G, Casali L, Bruyns J, Himpens J, Cadiere GB: Single-access laparoscopic surgery using new curved reusable instruments: initial hundred patients. Surg Technol Int. 2010, 20: 21-35.PubMed
15.
go back to reference Chiu CG, Nguyen NH, Bloom SW: Single-incision laparoscopic appendectomy using conventional instruments: an initial experience using a novel technique. Surg Endosc. 2011, 25: 1153-9. 10.1007/s00464-010-1332-3.CrossRefPubMed Chiu CG, Nguyen NH, Bloom SW: Single-incision laparoscopic appendectomy using conventional instruments: an initial experience using a novel technique. Surg Endosc. 2011, 25: 1153-9. 10.1007/s00464-010-1332-3.CrossRefPubMed
16.
go back to reference Teoh AY, Chiu PW, Wong TC, Wong SK, Lai PB, Ng EK: A case-controlled comparison of single-site access versus conventional three-port laparoscopic appendectomy. Surg Endosc. 2011, 25 (5): 1415-9. 10.1007/s00464-010-1406-2.CrossRefPubMed Teoh AY, Chiu PW, Wong TC, Wong SK, Lai PB, Ng EK: A case-controlled comparison of single-site access versus conventional three-port laparoscopic appendectomy. Surg Endosc. 2011, 25 (5): 1415-9. 10.1007/s00464-010-1406-2.CrossRefPubMed
17.
go back to reference Vidal O, Ginestà C, Valentini M, Martí J, Benarroch G, García-Valdecasas JC: Suprapubic single-incision laparoscopic appendectomy: a nonvisible-scar surgical option. Surg Endosc. 2011, 25 (4): 1019-23. 10.1007/s00464-010-1307-4.CrossRefPubMed Vidal O, Ginestà C, Valentini M, Martí J, Benarroch G, García-Valdecasas JC: Suprapubic single-incision laparoscopic appendectomy: a nonvisible-scar surgical option. Surg Endosc. 2011, 25 (4): 1019-23. 10.1007/s00464-010-1307-4.CrossRefPubMed
18.
go back to reference Kroh M, El-Hayek K, Rosenblatt S, Chand B, Escobar P, Kaouk J, Chalikonda S: First human surgery with a novel single-port robotic system: cholecystectomy using the da Vinci Single-Site platform. Surg Endosc. 2011 Kroh M, El-Hayek K, Rosenblatt S, Chand B, Escobar P, Kaouk J, Chalikonda S: First human surgery with a novel single-port robotic system: cholecystectomy using the da Vinci Single-Site platform. Surg Endosc. 2011
19.
go back to reference Hayashi M, Asakuma M, Komeda K, Miyamoto Y, Hirokawa F, Tanigawa N: Effectiveness of a surgical glove port for single port surgery. World J Surg. 2010, 34 (10): 2487-9. 10.1007/s00268-010-0649-3.CrossRefPubMed Hayashi M, Asakuma M, Komeda K, Miyamoto Y, Hirokawa F, Tanigawa N: Effectiveness of a surgical glove port for single port surgery. World J Surg. 2010, 34 (10): 2487-9. 10.1007/s00268-010-0649-3.CrossRefPubMed
20.
go back to reference Kim HJ, Lee JI, Lee YS, Lee IK, Park JH, Lee SK, Kang WK, Cho HM, You YK, Oh ST: Single-port transumbilical laparoscopic appendectomy: 43 consecutive cases. Surg Endosc. 2010, 24 (11): 2765-9. 10.1007/s00464-010-1043-9.CrossRefPubMed Kim HJ, Lee JI, Lee YS, Lee IK, Park JH, Lee SK, Kang WK, Cho HM, You YK, Oh ST: Single-port transumbilical laparoscopic appendectomy: 43 consecutive cases. Surg Endosc. 2010, 24 (11): 2765-9. 10.1007/s00464-010-1043-9.CrossRefPubMed
21.
go back to reference Ma J, Cassera MA, Spaun GO, Hammill CW, Hansen PD, Aliabadi-Wahle S: Randomized controlled trial comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy. Ann Surg. 2011, 254 (1): 22-7. 10.1097/SLA.0b013e3182192f89.CrossRefPubMed Ma J, Cassera MA, Spaun GO, Hammill CW, Hansen PD, Aliabadi-Wahle S: Randomized controlled trial comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy. Ann Surg. 2011, 254 (1): 22-7. 10.1097/SLA.0b013e3182192f89.CrossRefPubMed
22.
go back to reference Langer K: Zur Anatomie und Physiologie der Haut. Über die Spaltbarkeit der Cutis. Sitzungsbericht der Mathematisch-naturwissenschaftlichen Classe der Wiener Kaiserlichen. 1861, Academie der Wissenschaften Abt (44) Langer K: Zur Anatomie und Physiologie der Haut. Über die Spaltbarkeit der Cutis. Sitzungsbericht der Mathematisch-naturwissenschaftlichen Classe der Wiener Kaiserlichen. 1861, Academie der Wissenschaften Abt (44)
23.
go back to reference Kollmar O, Z'graggen K, Schilling MK, Buchholz BM, Buchler MW: The suprapubic approach for laparoscopic appendectomy. Surg Endosc. 2002, 16: 504-8. 10.1007/s00464-001-9027-4.CrossRefPubMed Kollmar O, Z'graggen K, Schilling MK, Buchholz BM, Buchler MW: The suprapubic approach for laparoscopic appendectomy. Surg Endosc. 2002, 16: 504-8. 10.1007/s00464-001-9027-4.CrossRefPubMed
24.
go back to reference Mostafa G, Matthews BD, Sing RF, Kercher KW, Heniford T: Mini-laparoscopic versus laparoscopic approach to appendectomy. BMC Surgery. 2001, 1: 4-10.1186/1471-2482-1-4.PubMedCentralCrossRefPubMed Mostafa G, Matthews BD, Sing RF, Kercher KW, Heniford T: Mini-laparoscopic versus laparoscopic approach to appendectomy. BMC Surgery. 2001, 1: 4-10.1186/1471-2482-1-4.PubMedCentralCrossRefPubMed
25.
go back to reference de Kok HJ: A new technique for resecting the non-inflamed not-adhesive appendix through a mini-laparotomy with the aid of the laparoscope. Arch Chir Neerl. 1997, 29 (3): 195-8. de Kok HJ: A new technique for resecting the non-inflamed not-adhesive appendix through a mini-laparotomy with the aid of the laparoscope. Arch Chir Neerl. 1997, 29 (3): 195-8.
26.
go back to reference Barbaros U, Sümer A, Tunca F, Gözkün O, Demirel T, Bilge O, Randazzo V, Dinççag A, Seven R, Mercan S, Budak D: Our early experiences with single-incision laparoscopic surgery: the first 32 patients. Surg Laparosc Endosc Percutan Tech. 2010, 20 (5): 306-11. 10.1097/SLE.0b013e3181f20cf6.CrossRefPubMed Barbaros U, Sümer A, Tunca F, Gözkün O, Demirel T, Bilge O, Randazzo V, Dinççag A, Seven R, Mercan S, Budak D: Our early experiences with single-incision laparoscopic surgery: the first 32 patients. Surg Laparosc Endosc Percutan Tech. 2010, 20 (5): 306-11. 10.1097/SLE.0b013e3181f20cf6.CrossRefPubMed
27.
go back to reference Budzynski A, Matlok M, Pedziwiatr M, Budzynski P, Tusinski M, Zub-Pokrowiecka A, Gwózdz A, Karcz D: SILS (Single Incision Laparoscopic Surgery) - new surgical approach to peritoneal cavity. Adv Med Sci. 2011, 56 (1): 18-24. 10.2478/v10039-011-0007-1.CrossRefPubMed Budzynski A, Matlok M, Pedziwiatr M, Budzynski P, Tusinski M, Zub-Pokrowiecka A, Gwózdz A, Karcz D: SILS (Single Incision Laparoscopic Surgery) - new surgical approach to peritoneal cavity. Adv Med Sci. 2011, 56 (1): 18-24. 10.2478/v10039-011-0007-1.CrossRefPubMed
28.
go back to reference Cho MS, Min BS, Hong YK, Lee WJ: Single-site versus conventional laparoscopic appendectomy: comparison of short-term operative outcomes. Surg Endosc. 2011, 25 (1): 36-40. 10.1007/s00464-010-1124-9.CrossRefPubMed Cho MS, Min BS, Hong YK, Lee WJ: Single-site versus conventional laparoscopic appendectomy: comparison of short-term operative outcomes. Surg Endosc. 2011, 25 (1): 36-40. 10.1007/s00464-010-1124-9.CrossRefPubMed
29.
go back to reference Chow A, Purkayastha S, Nehme J, Darzi LA, Paraskeva P: Single incision laparoscopic surgery for appendicectomy: a retrospective comparative analysis. Surg Endosc. 2010, 24 (10): 2567-74. 10.1007/s00464-010-1004-3.CrossRefPubMed Chow A, Purkayastha S, Nehme J, Darzi LA, Paraskeva P: Single incision laparoscopic surgery for appendicectomy: a retrospective comparative analysis. Surg Endosc. 2010, 24 (10): 2567-74. 10.1007/s00464-010-1004-3.CrossRefPubMed
30.
go back to reference Chouillard E, Dache A, Torcivia A, Helmy N, Ruseykin I, Gumbs A: Single-incision laparoscopic appendectomy for acute appendicitis: a preliminary experience. Surg Endosc. 2010, 24 (8): 1861-5. 10.1007/s00464-009-0860-1.CrossRefPubMed Chouillard E, Dache A, Torcivia A, Helmy N, Ruseykin I, Gumbs A: Single-incision laparoscopic appendectomy for acute appendicitis: a preliminary experience. Surg Endosc. 2010, 24 (8): 1861-5. 10.1007/s00464-009-0860-1.CrossRefPubMed
31.
go back to reference Feinberg EJ, O'Connor DJ, Feinberg ML, Vemulapalli P, Camacho D: Single-incision laparoscopic appendectomy: an early experience. Am Surg. 2011, 77 (3): 286-9.PubMed Feinberg EJ, O'Connor DJ, Feinberg ML, Vemulapalli P, Camacho D: Single-incision laparoscopic appendectomy: an early experience. Am Surg. 2011, 77 (3): 286-9.PubMed
32.
go back to reference Frutos MD, Abrisqueta J, Luján JA, García A, Hernández Q, Valero G, Parrilla P: Single incision transumbilical laparoscopic appendectomy: initial experience. Cir Esp. 2011, 89 (1): 37-41. 10.1016/j.ciresp.2010.09.008.CrossRefPubMed Frutos MD, Abrisqueta J, Luján JA, García A, Hernández Q, Valero G, Parrilla P: Single incision transumbilical laparoscopic appendectomy: initial experience. Cir Esp. 2011, 89 (1): 37-41. 10.1016/j.ciresp.2010.09.008.CrossRefPubMed
33.
go back to reference Hong TH, Kim HL, Lee YS, Kim JJ, Lee KH, You YK, Oh SJ, Park SM: Transumbilical single-port laparoscopic appendectomy (TUSPLA): scarless intracorporeal appendectomy. J Laparoendosc Adv Surg Tech A. 2009, 19 (1): 75-8. 10.1089/lap.2008.0338.CrossRefPubMed Hong TH, Kim HL, Lee YS, Kim JJ, Lee KH, You YK, Oh SJ, Park SM: Transumbilical single-port laparoscopic appendectomy (TUSPLA): scarless intracorporeal appendectomy. J Laparoendosc Adv Surg Tech A. 2009, 19 (1): 75-8. 10.1089/lap.2008.0338.CrossRefPubMed
34.
go back to reference Kang KC, Lee SY, Kang DB, Kim SH, Oh JT, Choi DH, Park WC, Lee JK: Application of single incision laparoscopic surgery for appendectomies in patients with complicated appendicitis. J Korean Soc Coloproctol. 2010, 26 (6): 388-94. 10.3393/jksc.2010.26.6.388.PubMedCentralCrossRefPubMed Kang KC, Lee SY, Kang DB, Kim SH, Oh JT, Choi DH, Park WC, Lee JK: Application of single incision laparoscopic surgery for appendectomies in patients with complicated appendicitis. J Korean Soc Coloproctol. 2010, 26 (6): 388-94. 10.3393/jksc.2010.26.6.388.PubMedCentralCrossRefPubMed
35.
go back to reference Lee JA, Sung KY, Lee JH, Lee do S: Laparoscopic appendectomy with a single incision in a single institute. J Korean Soc Coloproctol. 2010, 26 (4): 260-4. 10.3393/jksc.2010.26.4.260.PubMedCentralCrossRefPubMed Lee JA, Sung KY, Lee JH, Lee do S: Laparoscopic appendectomy with a single incision in a single institute. J Korean Soc Coloproctol. 2010, 26 (4): 260-4. 10.3393/jksc.2010.26.4.260.PubMedCentralCrossRefPubMed
36.
go back to reference Lee YS, Kim JH, Moon EJ, Kim JJ, Lee KH, Oh SJ, Park SM, Hong TH: Comparative study on surgical outcomes and operative costs of tra nsumbilicalsingle-port laparoscopic appendectomy versus conventional laparoscopic appendectomy in adult patients. Surg Laparosc Endosc Percutan Tech. 2009, 19 (6): 493-6. 10.1097/SLE.0b013e3181c15493.CrossRefPubMed Lee YS, Kim JH, Moon EJ, Kim JJ, Lee KH, Oh SJ, Park SM, Hong TH: Comparative study on surgical outcomes and operative costs of tra nsumbilicalsingle-port laparoscopic appendectomy versus conventional laparoscopic appendectomy in adult patients. Surg Laparosc Endosc Percutan Tech. 2009, 19 (6): 493-6. 10.1097/SLE.0b013e3181c15493.CrossRefPubMed
37.
go back to reference Nguyen NT, Reavis KM, Hinojosa MW, Smith BR, Stamos MJ: A single-port technique for laparoscopic extended stapled appendectomy. Surg Innov. 2009, 16 (1): 78-81.CrossRefPubMed Nguyen NT, Reavis KM, Hinojosa MW, Smith BR, Stamos MJ: A single-port technique for laparoscopic extended stapled appendectomy. Surg Innov. 2009, 16 (1): 78-81.CrossRefPubMed
38.
go back to reference Raakow R, Jacob DA: Initial experience in laparoscopic single-port appendectomy: a pilot study. Dig Surg. 2011, 28 (1): 74-9. 10.1159/000322921.CrossRefPubMed Raakow R, Jacob DA: Initial experience in laparoscopic single-port appendectomy: a pilot study. Dig Surg. 2011, 28 (1): 74-9. 10.1159/000322921.CrossRefPubMed
39.
go back to reference Saber AA, Elgamal MH, El-Ghazaly TH, Dewoolkar AV, Akl A: Simple technique for single incision transumbilical laparoscopic appendectomy. Int J Surg. 2010, 8 (2): 128-30. 10.1016/j.ijsu.2009.12.001.CrossRefPubMed Saber AA, Elgamal MH, El-Ghazaly TH, Dewoolkar AV, Akl A: Simple technique for single incision transumbilical laparoscopic appendectomy. Int J Surg. 2010, 8 (2): 128-30. 10.1016/j.ijsu.2009.12.001.CrossRefPubMed
40.
go back to reference Roberts KE: True single-port appendectomy: first experience with the "puppeteer technique". Surg Endosc. 2009, 23 (8): 1825-30. 10.1007/s00464-008-0270-9.CrossRefPubMed Roberts KE: True single-port appendectomy: first experience with the "puppeteer technique". Surg Endosc. 2009, 23 (8): 1825-30. 10.1007/s00464-008-0270-9.CrossRefPubMed
41.
go back to reference Yu J, Wang YN, Hu YF, Cheng X, Zhen L, Li GX: Single-incision laparoscopic appendectomy performed above the pubic symphysis - a new scarless approach. Minim Invasive Ther Allied Technol. 2011, 20 (1): 18-21. 10.3109/13645706.2010.518672.CrossRefPubMed Yu J, Wang YN, Hu YF, Cheng X, Zhen L, Li GX: Single-incision laparoscopic appendectomy performed above the pubic symphysis - a new scarless approach. Minim Invasive Ther Allied Technol. 2011, 20 (1): 18-21. 10.3109/13645706.2010.518672.CrossRefPubMed
Metadata
Title
Single port laparoscopic appendectomy: are we pursuing real advantages?
Authors
Nereo Vettoretto
Vincenzo Mandalà
Publication date
01-12-2011
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2011
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/1749-7922-6-25

Other articles of this Issue 1/2011

World Journal of Emergency Surgery 1/2011 Go to the issue