Single Incision Laparoscopic Appendectomy (SILA) in our hospital

Okada Tomoaki, Imai Yoshinori, Nakagawa Yusuke, Yamauchi Tatsuo, Mizumoto Tetsuya, Yamasita Michiko, Ishida Naoki, Matsumura Masaru, Nakamura Tarou, Kiyochi Hidenori, Okada Kenzo, Kajiwara Shinsuke

Uwajima City Hospital,Department of surgery

Introduction: Laparoscopic appendectomy for acute appendicitis is reported to alleviate postoperative pain, shorten the length of hospitalization and decrease in the incidence of surgical site infection in comparison to an open appendectomy (OA). Single incision laparoscopic surgery (SILS) is a scarless technique, performed through a single small incision hidden in the umbilicus. The Aim of this study is to introduce the method of single incision laparoscopic appendectomy(SILA) in our hospital, and to compare the procedure with conventional OA.

Methods: The SILA was initiated with a 15 mm Z shape incision on the umbilicus and the placement of a wound protector. A surgical glove was fixed to the outer ring of the wound retractor. Three 5 mm ports were placed at the individual fingers. Pneumoperitoneum was established, and the mesoappendix was grasped and the appendix was pulled out through the umbilicus. The surgical grove was removed and appendectomy was performed using the same method as OA. Sixty catarrhal or phlegmonous appendicitis patients were included in this study between August 2011 and July 2012. The Operative time, blood loss, complications, and length of hospitalization were examined retrospectively.

Results: There were 11 patient in the SILA group and 49 in the OA group, with a mean operative time of 57.1 minutes in the SILA and 46.8 minutes in the OA. The mean blood loss was 7.4 ml in the SILA and 8.1 ml in the OA. The mean length of hospitalization was 5.3 days in both groups. There were not complications in SILA.

Conclusion: Although, the operative time of SILA was longer than OA, the other results were comparable to OA. SILA is useful method for catarrhal or phlegmonous appendicitis with an obvious cosmetic benefit, especially for a patient with cosmetic needs.

Session: Poster Presentation

Program Number: P487