Abstract

DUZA, Guillermo et al. Single-access laparoscopic appendectomy with straight instrument; initial experience. rev. colomb. cir. [online]. 2014, vol.29, n.1, pp.25-31. ISSN 2011-7582.

Introduction: Acute appendicitis is the most common abdominal surgical entity, with 250,000 new cases being annually reported in the USA. Material and methods: This is a prospective, descriptive, and cohort study, of 43 laparoscopic appendectomies that were performed in the period April and December of 2012, 25 by the conventional three trocar approach. In four cases in which the initial technique was the single access laparoscopy, it became necessary to use one or two accessory ports because of peritonitis. Fourteen were performed by the single access approach, six females and eight males, with an average age of 20.6 years ranging between 15 and 27 years. Results: Patients were admitted because of 24 to 72 hours of abdominal pain over the right lower quadrant. Intraoperative diagnosis was congestive acute appendicitis in one patient, phlegmonous appendicitis in nine, gangrenous appendicitis in three, and gangrenous appendicitis with generalized peritonitis in one. Average operating time was 54.28 minutes (ranging 25 to 75 minutes). The average pain scale (from 1 to 10) after 24 hours was 2.42 (range 1 to 8). The average hospital stay was 1.91 days, ranging from 1 to 6. Degree of satisfaction with the cosmetic result was 9.5, ranging between 8 and 10. Conclusions: This novel technique is safe, effective and reproducible and has all the advantages of laparoscopic surgery. Cosmetic result appears superior when compared with conventional laparoscopic multiport surgery.

Keywords : appendicitis; appendectomy; laparoscopy; surgical procedures; minimally invasive.

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