Easily Applicable Single-incision Laparoscopic Appendectomy Using Straightforward Instrumental Alignment and...

Area of Science:

• Minimally Invasive Surgery
• Surgical Education
• Gastrointestinal Surgery

Background:

• Laparoscopic appendectomy is a frequent surgical procedure.
• Single-incision laparoscopic appendectomy (SILA) is a safe and feasible alternative to conventional laparoscopic appendectomy (CLA).
• Novice surgeons encounter difficulties with SILA due to reversed instrument triangulation.

Purpose of the Study:

• To present an easily applicable technique for SILA.
• To adapt the instrument alignment from CLA for SILA.
• To reduce the learning curve for novice surgeons performing SILA.

Main Methods:

• A series of 61 consecutive patients underwent SILA between January 2019 and December 2019.
• Acute appendicitis was diagnosed preoperatively using CT or ultrasound.
• A 3-channel Glove port and conventional laparoscopic instruments were utilized.

Main Results:

• The mean operative time was 37.5±17.0 minutes.
• Conversion to a multi-port procedure occurred in only 1 case.
• Postoperative complications (wound issues, bowel obstruction) were observed in 13.1% of patients, with a mean hospital stay of 2.5±1.3 days.

Conclusions:

• The adapted CLA instrument alignment was successfully implemented in SILA.
• This novel SILA technique simplifies the procedure for surgeons.
• The technique is expected to decrease the learning curve for novice surgeons performing single-incision laparoscopic surgery.