Single-site versus conventional laparoscopic appendectomy: comparison of short-term operative outcomes.

Cho, Min-Soo; Min, Byung Soh; Hong, Young-Ki; Lee, Woo-Jung

BACKGROUND Recent developments in minimally invasive surgery have introduced scarless surgeries such as natural orifice transluminal endoscopic surgery (NOTES) and single-site laparoscopic surgery. Among surgical procedures, the appendectomy is one of those targeted for early adoption of new minimally invasive surgical techniques. To date, however, only a limited number of case series have been reported. Thus, the current study aimed to evaluate the safety and feasibility of single-site laparoscopic appendectomy (SSLA) compared with conventional laparoscopic appendectomy (CLA). METHODS The study enrolled 43 patients who consecutively received laparoscopic appendectomy and divided them into SSLA and CLA groups. The clinical characteristics and short-term operative outcomes of these patients were reviewed and compared. RESULTS The 23 patients receiving SSLA did not differ from the 20 patients receiving CLA in terms of clinical characteristics including gender, age, body mass index (BMI), location of appendix, and severity of inflammation. Likewise, operation times and postoperative complication rates did not differ between the two groups. Short-term operative outcomes such as visual analog pain score and hospital stay were not different. The incision was shorter for SSLA (22.9 ± 3.9 mm) than for CLA (29.0 ± 3.0 mm) (p < 0.001). CONCLUSIONS The results of the current study suggest that SSLA is a feasible surgical alternative to CLA with an equivalent level of safety. The data also suggest that SSLA results in better cosmetic outcomes than CLA. Data from larger research studies are necessary to confirm these results and validate the use of SSLA over CLA.