Laparoendoscopic single-site surgery appendectomy.
BACKGROUND
Laparoscopic appendectomy via the three-trocar technique is widely used for appendectomy. This report describes the initial experience with laparoendoscopic single-site surgery (LESS) appendectomy.


METHODS
Between December 2008 and March 2009, patients with acute appendicitis admitted to the General Surgery and Emergency Unit of the authors' institution who agreed to undergo LESS appendectomy were included in a prospective study. All operations were performed by the same surgical team specially trained in this type of emergency surgery. The umbilicus was the sole point of entry for all patients, and the same operative technique was used in all cases. The data for patients undergoing LESS appendectomy were compared with the data from an uncontrolled group of patients undergoing standard laparoscopic appendectomy during the same study period.


RESULTS
The LESS and standard appendectomy groups included 15 patients each. The LESS procedure was performed successfully for all the patients, and none required conversion to an open procedure or a conventional laparoscopic appendectomy by the addition of more entry ports. The mean operating time of 51 min in the LESS group was not significantly different from the 46 min in the standard laparoscopic appendectomy group.


CONCLUSIONS
In this study, LESS appendectomy was technically feasible and safe, representing a reproducible alternative to standard laparoscopic appendectomy.
Vidal
Oscar
O
General Surgery and Emergency Unit, Department of Digestive Surgery, Digestive Diseases and Metabolism Institute, Hospital Clínic i Provincial, Universitat de Barcelona, Villarroel 170, 9th Stair, 4th Floor, 08036 Barcelona, Spain. ovidal@clinic.ub.es
Valentini
Mauro
M
Ginestà
Cesar
C
Martí
Josep
J
Espert
Juan J
JJ
Benarroch
Guerson
G
García-Valdecasas
Juan C
JC
D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010147:Pain Measurement; D011183:Postoperative Complications; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
Surg Endosc. 2006 Mar;20(3):495-9
16437274
Surg Endosc. 1998 Feb;12(2):177-8
9479738
Int Braz J Urol. 2008 Jul-Aug;34(4):413-21; discussion 421
18778492
Obes Surg. 2008 Oct;18(10):1338-42
18688685
Surg Laparosc Endosc Percutan Tech. 2007 Oct;17(5):375-9
18049395
Cochrane Database Syst Rev. 2004 Oct 18;(4):CD001546
15495014
J Laparoendosc Adv Surg Tech A. 2009 Feb;19(1):75-8
19196084
Endoscopy. 1983 Mar;15(2):59-64
6221925
Ann Surg. 2004 Feb;239(2):182-5
14745325
Ann Surg. 2008 Oct;248(4):687-9
18936583
Lancet. 1993 Sep 11;342(8872):633-7
8103144
Dig Surg. 2008;25(5):394-9
19065056
Rozhl Chir. 1996 Jan;75(1):15-8
8768951
Endoscopy. 2008 May;40(5):428-31
18459078
Surg Endosc. 2002 May;16(5):833-5
11997832
Urology. 2008 Jan;71(1):3-6
18242353
Radiology. 2004 Feb;230(2):472-8
14688403
J Gastrointest Surg. 2009 Jan;13(1):159-62
18972166
Lancet Oncol. 2005 Jul;6(7):477-84
15992696
J Endourol. 2008 Aug;22(8):1573-6
18681804
Surg Endosc. 2009 Jun;23(6):1393-7
19118436
J Laparoendosc Adv Surg Tech A. 1999 Aug;9(4):361-4
10488834