Single-Port Laparoscopic Interval Appendectomy for Perforated Appendicitis With a Periappendiceal Abscess

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Surgical Innovation

Background:

• Nonoperative management followed by interval appendectomy is standard for perforated appendicitis with abscess.
• Single-port laparoscopic surgery (SPLS) is an evolving minimally invasive technique with increasing applications.
• Multichannel single-port systems facilitate complex laparoscopic procedures.

Purpose of the Study:

• To evaluate the feasibility and safety of using a multichannel single-port for interval appendectomy in patients with perforated appendicitis and abscess.
• To assess the outcomes of single-port laparoscopic surgery (SPLS) in this specific patient population.

Main Methods:

• A prospective study of 25 adult patients undergoing single-port laparoscopic interval appendectomy for perforated appendicitis with periappendiceal abscess.
• Procedures utilized a multichannel single-port, with or without a needlescopic grasper.
• Data collected included operative time, conversion rates, complication rates, and length of hospital stay.

Main Results:

• Of 25 patients, 9 (36%) required percutaneous drainage, and 3 (12%) required conversion to reduced-port surgery due to adhesions.
• Pure SPLS was performed in 13 patients (52%), and SPLS with a 2-mm needle instrument in 9 patients (36%).
• Median incision length was 2.5 cm, with a median hospital stay of 3 days. Postoperative complications occurred in 8% of patients.

Conclusions:

• Single-port laparoscopic interval appendectomy using a multichannel single-port is a feasible and safe option for selected patients.
• This approach may offer benefits in terms of cosmesis and potentially recovery.
• Further research with larger cohorts is warranted to confirm long-term outcomes.