The experience of transumbilical endoscopic appendectomies.
Minimally invasive surgery is being widely accepted in various fields of surgery. Although several appendectomy techniques have been reported but, there is no standardization. We report here the experiences of transumbilical endoscopic appendectomy in humans. Between July 2008 and September 2010, ten patients with appendicitis successfully underwent transumbilical endoscopic appendectomies. There were 7 cases of suppurative, 2 cases of gangrenous and 1 case of perforated in operative findings. The ages of the patients were 13-56 years (mean age, 32.7 ± 15.4 years). Under general anesthesia, a 15-mm port was inserted through the umbilicus and then a two-channel endoscope was inserted in the peritoneal cavity. After appendix identification, counter-traction of the appendix with a direct abdominal wall puncture using a straight round needle prolene was performed to achieve good visualization of the operative field. Tissue dissection was performed using an endoscopic needle knife. Tissue grasping and resected appendix retrieval were done with endoscopic forceps. The average operation time was 79.5 ± 23.6 minutes (range, 45 to 110 minutes). No procedures were converted to laparoscopic or open appendectomy. Hospital stay was 4-6 days. All patients completely recovered without complications. As it is highly maneuverable, we believe transumbilical endoscopic appendectomy can be a feasible method. And, as surgeons want to proceed from laparoscopic surgery to natural orifice transluminal endoscopic surgery, this procedure could be a triable method.
Department of Surgery, Chungbuk National University College of Medicine, Medical Research Institute, Cheongju, Korea.
Chung-Heon
CH
Lee
Department of Internal Medicine, Chungbuk National University College of Medicine, Medical Research Institute, Cheongju, Korea.
Won Joong
WJ
Jeon
Department of Internal Medicine, Chungbuk National University College of Medicine, Medical Research Institute, Cheongju, Korea.
Sei Jin
SJ
Youn
Department of Surgery, Chungbuk National University College of Medicine, Medical Research Institute, Cheongju, Korea.
Hyo Young
HY
Yun
Department of Surgery, Chungbuk National University College of Medicine, Medical Research Institute, Cheongju, Korea.
Lee-Chan
LC
Jang
Department of Surgery, Chungbuk National University College of Medicine, Medical Research Institute, Cheongju, Korea.
Jae-Woon
JW
Choi
Department of Surgery, Chungbuk National University College of Medicine, Medical Research Institute, Cheongju, Korea.
Young Jin
YJ
Song
Department of Surgery, Chungbuk National University College of Medicine, Medical Research Institute, Cheongju, Korea.
Dong Hee
DH
Ryu
Appendectomy; Endoscopy; Transumbilical approach