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Related Experiment Videos

The suprapubic approach for laparoscopic appendectomy.

O Kollmar1, K Z'graggen, M K Schilling

  • 1Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, 3010 Bern, Switzerland.

Surgical Endoscopy
|April 3, 2002
PubMed
Summary

Two suprapubic trocar techniques for laparoscopic appendectomy were evaluated. The two-suprapubic trocar approach yielded superior cosmetic results and patient preference compared to standard or single-suprapubic trocar methods.

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Area of Science:

  • Surgical Innovation
  • Minimally Invasive Surgery
  • Cosmetic Outcomes in Surgery

Background:

  • Laparoscopic appendectomy is preferred over open appendectomy due to superior cosmetic results.
  • Two novel laparoscopic appendectomy access routes using suprapubic incisions were developed.
  • Comparison of three distinct laparoscopic appendectomy access methods was performed.

Purpose of the Study:

  • To compare operative characteristics, morbidity, outcomes, and patient preferences for three laparoscopic appendectomy techniques.
  • To evaluate patient satisfaction and perceived cosmetic results for different suprapubic trocar placements.
  • To determine the optimal laparoscopic appendectomy approach for patient satisfaction and cosmetic appeal.

Main Methods:

  • Retrospective study comparing 149 patients undergoing laparoscopic appendectomy across three techniques (January 1997 - August 2000).

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  • Assessment of operative results, morbidity, and hospital stay.
  • Patient preference surveys and interviews with healthy controls regarding cosmetic outcomes and technique preference.

    • Main Results:

    • Operative results, morbidity, and hospital stay were similar across all three techniques.
    • Patient satisfaction with cosmetic results increased significantly with suprapubic trocar use (25% technique 1 vs. 54% technique 2 vs. 100% technique 3).
    • The two-suprapubic trocar technique (technique 3) was overwhelmingly preferred for cosmetic results by both study patients and healthy controls.

    Conclusions:

    • Suprapubic trocar placement enhances the surgeon's working position during laparoscopic appendectomy.
    • A laparoscopic approach utilizing two suprapubic trocars provides the best cosmetic results.
    • Patient and healthy control opinions strongly favor the two-suprapubic trocar technique for aesthetic outcomes.