Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated...

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Appendicectomy, a procedure for acute appendicitis, has evolved from open to laparoscopic techniques.
• Single-incision laparoscopic appendicectomy (SILA) is a novel approach using a single incision for all ports.
• Comparisons between SILA and conventional laparoscopic appendicectomy (CLA) regarding efficacy and patient outcomes are ongoing.

Purpose of the Study:

• To evaluate the comparative efficacy of SILA versus CLA for acute appendicitis.
• To assess benefits, complications, and short-term outcomes of SILA compared to CLA.
• To update previous reviews on single-incision laparoscopic appendicectomy.

Main Methods:

• Included randomized controlled trials (RCTs) comparing SILA and CLA in patients over 10 years old with appendicitis.
• Searched multiple databases including CENTRAL, MEDLINE, Embase, and clinical trial registries up to January 2024.
• Extracted data and assessed risk of bias; calculated odds ratios and mean differences for outcomes.

Main Results:

• Eleven RCTs with 1373 participants were analyzed; evidence certainty was low to moderate.
• Postoperative pain and hospital stay were similar between SILA and CLA.
• SILA demonstrated superior cosmetic results but had a higher conversion rate to open surgery.

Conclusions:

• SILA is comparable to CLA for short-term outcomes like complications and recovery.
• SILA may offer better cosmetic satisfaction despite a potential increase in conversion rates.
• Further research is needed to fully understand long-term outcomes and optimize SILA techniques.