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Transumbilical laparoscopic appendectomy for acute appendicitis: a reliable one-port procedure
Shin-Yi Lee1, Hui-Ming Lee, Chih-Sung Hsieh
1Department of Pediatric Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123, Ta-Pei Road, Niao-Song Hsiang, Kaohsiung Hsien, Taiwan.
Surgical Endoscopy
|September 18, 2010
Summary
A novel transumbilical one-port laparoscopic appendectomy (TOPLA) allows a single surgeon to safely treat appendicitis. This minimally invasive technique reduces operative time and infection rates, offering better cosmetic results.
Area of Science:
- Minimally Invasive Surgery
- Surgical Techniques
- Appendicitis Management
Background:
- Emergency surgeries require high standards despite staffing challenges.
- A transumbilical one-port laparoscopic appendectomy (TOPLA) technique is presented.
- This method is designed for single-surgeon proficiency.
Purpose of the Study:
- To describe a safe and effective transumbilical one-port laparoscopic appendectomy (TOPLA).
- To evaluate the feasibility of TOPLA performed by a single surgeon.
- To compare TOPLA outcomes with traditional open appendectomy (OA).
Main Methods:
- 152 patients with simple and complicated appendicitis underwent TOPLA between 2006-2008.
- A single surgeon utilized a 10-mm laparoscope with a 5-mm working channel.
- Outcomes were compared to 112 patients who had open appendectomy (OA).
Main Results:
- TOPLA significantly reduced operative time (61.5 min) versus OA (118.3 min).
- Wound infection rates were significantly lower with TOPLA (0%) compared to OA (9.8%).
- TOPLA patients required less pain medication and had improved cosmetic outcomes.
Conclusions:
- TOPLA is a simple, safe, and effective laparoscopic procedure for appendicitis.
- It enables a single surgeon to manage appendicitis with excellent cosmetic results.
- TOPLA offers a viable alternative to standard laparoscopic and open procedures.
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It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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01:22Appendicitis-I: Introduction
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
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