title: Novel approach of single-port laparoscopic appendectomy as a solo surgery: A prospective cohort study.
abstract: BACKGROUND
  Recent advances in medical equipment and surgical techniques have enabled solo surgery, wherein a surgeon operates alone without the participation of other surgical members. However, the application of solo surgery in single-port laparoscopic surgery (SPLS) has been rarely reported.
  
  
  METHODS
  Prospectively collected databases of 60 patients who underwent solo-SPLS for appendicitis between March 2013 and June 2014 were retrospectively reviewed. Making a transumbilical incision into the peritoneal cavity was facilitated by using a Lone Star self-retaining retractor. After the establishment of a single port through the umbilicus, we installed a mechanical adjustable camera holder (Endoworld®LAP53 Holding Systems). It was anchored to the operating table rail and firmly held the laparoscope with a possibility to adjust the same as required by the operator. The operative method was identical to the SPLS appendectomy, except for the use of these instruments.
  
  
  RESULTS
  The median operation time was 50 min (25-120). None of the patients required open conversion, insertion of an additional port or help of a human assistant. The median length of hospital stay for all patients was 1.0 day (range: 1-3 days). The median dosage of required intravenous analgesics (ketorolac, 0.1 mg/kg of body weight) was 0.0 ampoule (0-4). The median interval to initiation of solid diet was 1 day (1-2). The incidence of postoperative complications was 8.3% (5/60).
  
  
  CONCLUSIONS
  Our results shows that solo-SPLS appendectomy could be performed without increasing operation time or postoperative complications when performed by a surgeon competent in performing SPLS appendectomy.
authors.affiliation: Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea.
authors.forename: Say-June
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea.
authors.forename: Byung-Jo
authors.initials: BJ
authors.lastname: Choi
authors.affiliation: Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea. Electronic address: zambo9@catholic.ac.kr.
authors.forename: Sang Chul
authors.initials: SC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D004867:Equipment Design; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome; D014472:Umbilicus; D055815:Young Adult
keywords: Appendectomy; Camera holder; Laparoscopy; Single-port laparoscopic surgery; Solo surgery