Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial

Area of Science:

• Minimally Invasive Surgery
• Surgical Outcomes Research
• Comparative Effectiveness Studies

Background:

• Single-site umbilical laparoscopic appendectomy is an emerging technique.
• Prospective comparative data for this approach were previously lacking.
• This study aimed to compare single-site versus 3-port laparoscopic appendectomy.

Purpose of the Study:

• To compare the efficacy and safety of single-site umbilical laparoscopic appendectomy versus standard 3-port laparoscopic appendectomy.
• To evaluate postoperative wound infection rates as the primary outcome.
• To assess secondary outcomes including operative time, recovery, and hospital charges.

Main Methods:

• A prospective, randomized trial involving 360 patients with uncomplicated appendicitis.
• Patients were randomized to either single-site umbilical or 3-port laparoscopic appendectomy.
• Exclusion criteria included perforated appendicitis; surgical technique varied by surgeon.

Main Results:

• No significant difference in postoperative wound infection rates between the two groups.
• Single-site appendectomy resulted in longer operative times (mean 5 minutes longer).
• Increased surgical difficulty, narcotic use, and hospital charges were observed with the single-site approach.

Conclusions:

• Single-site umbilical laparoscopic appendectomy is comparable to 3-port in terms of wound infection and recovery.
• The single-site approach leads to increased operative time and costs, though likely of marginal clinical significance.
• Further research may explore optimizing single-site techniques to mitigate these drawbacks.