Laparoendoscopic Single-site Surgery (less) Abdominal Exploration in Acute Abdomen: One Unit Experiences With 90 Consecutive Cases

Duo Li, MD, Chunbe Kang, MD, Jinhong Liu, MD. Dept. Surgery, Aerospace Center Hospital, Peking University

Objective:Laparoendoscopic single-site surgery (LESS) is a newly emerging advanced minimally invasive surgical procedure. Patients suffering from acute abdomen may also benefit from such advancement; here we report our experience by using a single small incision through the umbilicus in surgical acute abdomen .We aimed to investigate the feasibility, safety and advantage of the LESS abdominal exploration in diagnosis and treatment of acute abdomens.

Method: We review the clinical data of 90 cases of surgical acute abdomen admitted between Jan. and May2011, which were judged need surgical intervention, and enroll in for laparoendoscopic single-site surgery (LESS) abdominal exploration at the Aerospace Center Hospital. The Procedures were performed by one group of surgeons through a 15MM single umbilical incision and by 10mm laparoscope with a 5mm instrument channel with or without another 5MM laparoscopic forceps.

Results: In 90 patients, 76 cases were acute appendicitis and successfully performed appendectomy by pull out the appendix through the umbilicus using a grasper through the 5mm instrument channel. 3 of them were converted two-port laparoscopic appendectomy and 1 was 3 port because of severe adhesion. None of them was converted to open appendectomy. 1 case with hemorrhage enteritis was performed small bowel resection through the umbilical single port. 2 were perforated ulcer by laparoscopic repair through the umbilical port. 2 cases were pelvic inflammatory disease performed peritoneal lavage. All the patients were cured within 7 days. The average operation time were 60 min, hospital stay were 3days. The pain scales were 3-4 compare to 6-7 with open Surgery. The cosmetic effect was show in the picture.

Conclusion: Our empirically study suggested single port exploration for acute abdomen is safe and feasible, especially for those when the diagnosis is not certain. Laparoendoscopic single-site surgery (LESS) evaluation facilitates easier manipulation for misdiagnoses at operation thereby reducing unnecessary extra trocar and conversion to open technique. The surgical procedures are easier than traditional laparoscopic acute abdomen procedure if the involved organ could be pulling out through the umbilicus. Cosmetic effect was better.
 

View Poster