Single-incision Versus Conventional Laparoscopic Appendicectomy: A Comparative Study

Introduction: The aim of this study was to compare the results of single-incision laparoscopic appendicectomy (SILA) with conventional three-ports laparoscopic appendicectomy (LA) for uncomplicated appendicitis.

Methods: From March 2009 to August 2009, all cases of uncomplicated appendicitis (i.e. no perforation, no abscess formation) that had undergone either SILA or LA were included in this study. Data including patient demographics, operative details and postoperative outcomes were prospectively collected. Statistical analysis was performed using Mann-Whitney U test, Fisher’s exact and chi-squared tests for numerical and categorical variables respectively.

Results: Of the total of 50 patients with uncomplicated appendicitis, twenty-five had SILS and twenty-five received LA. Patient demographics between these two groups were similar in terms of age (p=0.46), sex (p=0.14) & ASA grade (p=0.54). There were no difference in terms operation time (mean 42 vs. 38mins, p=0.36), blood loss (mean 3.6 vs. 2.2ml, p=0.25) and hospital stay (mean 2.36 vs. 2.20days, p=0.69). All cases of SILS and LA were successfully completed without conversion. There was no mortality. Due to the preliminary experience of single-incision laparoscopic surgery, significantly more specialists performed SILA than residents (p=0.004).
Patients who had SILA received significantly more oral analgesic (mean 5.1 vs. 2.9tabs, p=0.004) but not opioid injections (p=0.40). Further analysis of the type of SILS used (multiple ports via single incision or Olympus Triport) showed less intake of oral analgesic in the Triport group.

Conclusions: This study confirms the feasibility and safety of SILA. Overall it is comparable with LA with the exception of wound pain which may be more severe in SILA group.

Session: Poster

Program Number: P491

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