Transumbilical single-port laparoscopic appendectomy (TUSPLA): scarless intracorporeal appendectomy.
BACKGROUND
Laparoscopic appendectomy is generally performed with the three-port system. In this study, we performed a unique single-port laparoscopic appendectomy, which we refer to as the transumbilical single-port laparoscopic appendectomy (TUSPLA).


METHODS
From April 19, 2008, 33 cases of TUSPLA were performed. A surgical glove was used as the "single-port" with an extra-small wound retractor, which was set up through a small umbilical incision. The surgical glove attached with one trocar and two pipes were then fixed to the outer ring of the wound retractor, which served as a single port with three working channels. Using this single-port system, TUSPLA was performed. The overall procedure was similar to that used for the three-port laparoscopic appendectomy.


RESULTS
TUSPLA was attempted in 33 patients (11 males and 22 females), with an average age of 31.2 years (range, 14-73). Average patient body mass index was 22.8 kg/m2 (range, 16.8-35.8). TUSPLA was successfully completed in 31 patients. In 2 cases, the operation was converted to the conventional three-port laparoscopic appendectomy due to a gangrenous change at the base of the appendix in 1 case and the need for drainage in another. Mean operation time was 40.8 minutes (range, 15-90), and mean postoperative hospital stay was 2.5 days (range, 1-11). Postoperative complications occurred in 3 cases; 2 cases were of localized pericecal abscess and 1 case was of omphalitis, and all were treated conservatively.


CONCLUSIONS
TUSPLA is a safe, effective technique that allows nearly scarless abdominal surgery.
Hong
Tae Ho
TH
Department of Surgery, Incheon St. Mary Hospital College of Medicine, The Catholic University of Korea, Incheon, Korea.
Kim
Hyung Lan
HL
Lee
Yoon Suk
YS
Kim
Jin Jo
JJ
Lee
Keun Ho
KH
You
Young Kyoung
YK
Oh
Se Jeong
SJ
Park
Seung Man
SM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*