title: A review of minimally invasive single-port/incision laparoscopic appendectomy.
abstract: BACKGROUND
  Single-port/incision laparoscopic appendectomy (SPILA) is a modern advancement toward stealth surgery, using a single point of entry. Despite the paucity of clinical data, it is increasingly being used to minimize scarring and, potentially, pain associated with the multiple entry points. We aimed to summarize and present available data on this new approach.
  
  
  METHODS
  All available databases until December 2010 including the Cochrane Controlled Trials Register, MEDLINE, and EMBASE were searched and cross-referenced for studies describing single-incision laparoscopic appendectomy. Case and experimental reports, series with fewer than 5 patients, and non-English articles were excluded. Outcome measures were operative time, postoperative hospital stay, pain scores, complications, conversion, and mortality, stratified according to type of SPILA approach. SPSS version 18.0.0 software was used for data collection.
  
  
  RESULTS
  Database query yielded 79 articles; 45 were included (1 randomized controlled trial, 44 case series). Total cases were 2806, with mean patient age for studies ranging from 7.0 to 37.5 years. No mortality was reported. The overall complication rate was 4.13%. The overall weighted mean operating time was 41.3 minutes (range, 15.0-95.9 minutes). The weighted mean hospital stay was 2.79 days (range, 1.0-6.6 days).
  
  
  CONCLUSIONS
  Although the incidence of complications with SPILA remains low and operating times between new and traditional approaches are comparable in case-based literature, adequately powered randomized trials are required to assess its effectiveness. Occurrence of long-term complication types remains unexplored.
authors.affiliation: University of Aberdeen, Aberdeen, Scotland, United Kingdom. haroon.rehman.06@aberdeen.ac.uk
authors.forename: Haroon
authors.initials: H
authors.lastname: Rehman
authors.forename: Tim
authors.initials: T
authors.lastname: Mathews
authors.forename: Irfan
authors.initials: I
authors.lastname: Ahmed
mesh_terms: D001062:Appendectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*