title: Treatment of acute appendicitis with one-port transumbilical laparoscopic-assisted appendectomy: a six-year, single-centre experience.
abstract: BACKGROUND
  Laparoscopic appendectomy is a feasible and safe alternative to open appendectomy for uncomplicated appendicitis. In the past decade several laparoscopic procedures have been described using one or more ports. We report our experience in treating acute appendicitis with one-port transumbilical laparoscopic-assisted appendectomy (TULAA).
  
  
  METHODS
  We performed 231 TULAA on patients in the period from November 2001 to September 2007. We introduced an 11 mm Hasson's port using open technique; an operative channel with 10 mm telescope and an atraumatic grasper were used. After intra-abdominal laparoscopic dissection, the appendix was exteriorised through the umbilical access. The appendectomy was performed outside the abdomen as in the open procedure; the operation was completed using only one port in 227 patients (98%), two and three ports in two patients (1%) while conversion to open surgery was needed in two patients (1%).
  
  
  RESULTS
  The average operating time was 38 minutes and the median time to discharge was three days. Four (1, 7%) early postoperative complications (two suppuration of the umbilical wound) with no major complications were observed.
  
  
  CONCLUSIONS
  Our results demonstrate that TULAA, which combines the advantages of both open and laparoscopic procedures, is a valid alternative form of treating uncomplicated appendicitis. If appendectomy cannot be completed with only one port, insertion of one or more ports may be necessary to safely conclude the procedure.
authors.affiliation: Division of Paediatric Surgery, Regina Margherita Children's Hospital, Turin, Italy. riccardoguan@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: Guanà
authors.forename: R
authors.initials: R
authors.lastname: Gesmundo
authors.forename: E
authors.initials: E
authors.lastname: Maiullari
authors.forename: E R
authors.initials: ER
authors.lastname: Bianco
authors.forename: V
authors.initials: V
authors.lastname: Bucci
authors.forename: L
authors.initials: L
authors.lastname: Ferrero
authors.forename: F
authors.initials: F
authors.lastname: Canavese
mesh_terms: D000293:Adolescent; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery