title: Pain after laparoscopic appendectomy: a comparison of transumbilical single-port and conventional laparoscopic surgery.
abstract: OBJECTIVE
  Conventional laparoscopic appendectomy is performed using three ports, and single-port appendectomy is an attractive alternative in order to improve cosmesis. The aim of this study was to compare pain after transumbilical single-port laparoscopic appendectomy (SA) with pain after conventional three-port laparoscopic appendectomy (TA).
  
  
  METHODS
  From April to September 2011, 50 consecutive patients underwent laparoscopic appendectomy for simple appendicitis without gangrene or perforation. Patients who had undergone appendectomy with a drainage procedure were excluded. The type of surgery was chosen based on patient preference after written informed consent was obtained. The primary endpoint was postoperative pain evaluated by the visual analogue scale score and postoperative analgesic use. Operative time, recovery of bowel function, and length of hospital stay were secondary outcome measures.
  
  
  RESULTS
  SA using a SILS port (Covidien) was performed in 17 patients. The other 33 patients underwent TA. Pain scores in the 24 hours after surgery were higher in patients who underwent SA (P = 0.009). The change in postoperative pain score over time was significantly different between the two groups (P = 0.021). SA patients received more total doses of analgesics (nonsteroidal anti-inflammatory drugs) in the 24 hours following surgery, but the difference was not statistically significant. The median operative time was longer for SA (P < 0.001).
  
  
  CONCLUSIONS
  Laparoscopic surgeons should be concerned about longer operation times and higher immediate postoperative pain scores in patients who undergo SA.
authors.affiliation: Department of Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyung Ook
authors.initials: HO
authors.lastname: Kim
authors.forename: Chang Hak
authors.initials: CH
authors.lastname: Yoo
authors.forename: Sung Ryol
authors.initials: SR
authors.lastname: Lee
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Son
authors.forename: Yong Lai
authors.initials: YL
authors.lastname: Park
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Shin
authors.forename: Hungdai
authors.initials: H
authors.lastname: Kim
authors.forename: Won Kon
authors.initials: WK
authors.lastname: Han