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True single-port appendectomy: first experience with the "puppeteer technique"
1Department of Surgery, Section of Gastrointestinal Surgery, Yale University School of Medicine, 40 Temple Street, Suite 7B, New Haven, CT 06510, USA. kurt.roberts@yale.edu
Surgical Endoscopy
|January 27, 2009
Summary
A novel true single-port appendectomy (TSPA) technique using a "puppeteer" method offers a safe, reproducible approach to laparoscopic appendectomy. This single-port surgery minimizes invasiveness, potentially reducing pain and improving cosmetic outcomes.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Laparoscopic appendectomy is a common minimally invasive surgical procedure.
- Reduced port techniques, including two-port and single-port assisted methods, have been developed.
- Traditional laparoscopic appendectomy typically uses three ports.
Purpose of the Study:
- To describe a novel true single-port appendectomy (TSPA) technique.
- To evaluate the safety and reproducibility of the TSPA using a "puppeteer" method.
- To present the initial outcomes of TSPA for appendicitis.
Main Methods:
- A case series of 14 consecutive patients undergoing TSPA for presumed appendicitis.
- The "puppeteer technique" utilizes an intra-abdominal loop and extracorporeal thread manipulation.
- Surgery was performed between July and December 2007 at Yale-New Haven Hospital.
Main Results:
- 13 out of 14 patients (93%) successfully underwent TSPA.
- One patient required conversion to a two-port appendectomy.
- The mean operative time was 87.5 minutes, with no major complications observed.
Conclusions:
- The "puppeteer technique" for TSPA is a safe and reproducible alternative to conventional laparoscopic appendectomy.
- TSPA offers potential benefits of reduced postoperative pain and improved cosmesis.
- Further randomized controlled trials are needed to validate this single-port approach.
