Single incision versus conventional multi-incision appendicectomy for suspected appendicitis.

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Appendicectomy is standard for acute appendicitis, with options including open and laparoscopic surgery.
• Single incision laparoscopic surgery (SILS) is a newer, less invasive approach to appendicectomy.
• Questions remain about SILS's patient benefits, satisfaction, complications, and long-term outcomes.

Purpose of the Study:

• To conduct a meta-analysis of trials comparing single-incision laparoscopic appendectomy with multi-incision laparoscopic appendectomy.
• To identify differences in patient outcomes between the two surgical approaches for appendicitis.

Main Methods:

• Searched electronic databases (MEDLINE/PubMed, EMBASE, CENTRAL) from 1980 to December 2010.
• Included randomized or quasi-randomized controlled trials comparing single-incision with multi-incision laparoscopic appendectomy.
• Searched reference lists, conference proceedings, and ongoing trial databases.

Main Results:

• No randomized controlled trials (RCTs) or prospectively controlled trials met the inclusion criteria.
• The available evidence consists solely of case series.
• The review is pending results from five ongoing trials.

Conclusions:

• No RCTs were identified comparing single-incision with multi-incision laparoscopic appendectomy.
• Definitive conclusions on the efficacy and safety of single-incision laparoscopic appendectomy cannot be drawn.
• High-quality prospective RCTs are necessary to evaluate laparoscopic approaches for appendicectomy.