Annals of Coloproctology

Original Article

Benign GI diease,Benign diesease & IBD,Surgical technique

Clinical outcomes of locking polymeric clip for laparoscopic appendectomy in patients with appendicitis: a retrospective comparison with loop ligature: Seokwon Kim, Byong Ho Jeon, Sang Sik Cho, Ui Sup Shin, Sun Mi Moon; Ann Coloproctol. 2022;38(2):160-165. Published online January 18, 2022; DOI: https://doi.org/10.3393/ac.2021.00598.0085

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Purpose
This study aimed to compare the clinical outcomes of laparoscopic appendectomy (LA) according to the method of appendiceal stump closure.
Methods
Patients who underwent LA for appendicitis between 2010 and 2020 were retrospectively reviewed. Patients were classified into locking polymeric clip (LPC) and loop ligature (LL) groups. Clinical outcomes were compared between the groups.
Results
LPC and LL were used in 188 (56.6%) and 144 patients (43.4%), respectively for appendiceal stump closure. No significant differences were observed in sex, age, comorbidities, and the severity of appendicitis between the groups. The median operative time was shorter in the LPC group than in the LL group (64.5 minutes vs. 71.5 minutes, P=0.027). The median hospital stay was longer in the LL group than in the LPC group (4 days vs. 3 days, P=0.020). Postoperative incidences of intraabdominal abscess and ileus were higher in the LL group than in the LPC group (4.2% vs. 1.1%, P=0.082 and 2.8% vs. 0%, P=0.035; respectively). The readmission rate was higher in the LL group than that in the LPC group (6.3% vs. 1.1%, P=0.012).
Conclusion
Using LPC for appendiceal stump closure during LA for appendicitis was associated with lower postoperative complication rate, shorter operative time, and shorter hospital stay compared to the use of LL. Operative time above 60 minutes and the use of LL were identified as independent risk factors for postoperative complications in LA. Therefore, LPC could be considered a more favorable closure method than LL during LA for appendicitis.

Citations

Citations to this article as recorded by

Comparison of polymeric clip and endoloop in laparoscopic appendectomy: A systematic review and meta-analysis
Aashish Kumar, Muhammad Saqlain Mustafa, Muhammad Ashir Shafique, Abdul Haseeb, Hussain Sohail Rangwala, Haimath Kumar, Burhanuddin Sohail Rangwala, Adarsh Raja, Sandesh Raja, Syed Muhammad Sinaan Ali
Surgery.2024; 176(5): 1329. CrossRef
Advantages of using a polymeric clip versus an endoloop during laparoscopic appendectomy in uncomplicated appendicitis: a randomized controlled study
Kil-yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
World Journal of Emergency Surgery.2023;[Epub] CrossRef

Case Report

Benign GI diease,Rare disease & stoma

Impending Rupture With a Twisted Huge Appendiceal Mucocele Treated With Totally Laparoscopic Resection: A Case Series: Hong-min Ahn, Si-Hak Lee; Ann Coloproctol. 2021;37(Suppl 1):S34-S38. Published online June 29, 2021; DOI: https://doi.org/10.3393/ac.2020.00150.0021

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Abstract PDF

Torsion of the appendix is rare, and appendiceal mucocele can be one of its causes. The first case was of a 49-year-old man who visited the emergency room (ER) for abdominal pain. Abdominal computed tomography (CT) showed appendiceal mucocele with suspected torsion and rupture. The patient underwent laparoscopic exploration and appendectomy. The second case was of a 69-year-old man who visited the ER for epigastric pain. Abdominal CT showed suspicious appendiceal mucocele with ischemic change, indicating torsion of the appendix. The twisted appendix was successfully removed by laparoscopic exploration. An appendiceal mucocele is one of the causes of twisted appendix. With torsion, the mucocele can be diagnosed as rupture by ischemia which may lead to pseudomyxoma peritonei. For this reason, open laparotomy has traditionally been preferred. However, an unruptured appendiceal mucocele or impending rupture with torsion of the appendiceal mucocele can be treated with totally laparoscopic surgery.

Citations

Citations to this article as recorded by

Uncommon cause of acute appendiceal torsion mucocele
Munyaradzi Gift Nyandoro, Vignesh Kumar Palanisamy, Rajesh Kumar Singh
BMJ Case Reports.2022; 15(7): e249175. CrossRef
Benign multicystic mesothelioma of appendiceal origin treated by hyperthermic intraperitoneal chemotherapy: A case report
Suk Jun Lee, Ji Hae Nahm, Jeonghyun Kang, Seung Hyuk Baik, Eun Jung Park
International Journal of Surgery Case Reports.2022; 99: 107665. CrossRef

Original Articles

Benign GI diease

Resident Learning Curve for Laparoscopic Appendectomy According to Seniority: Chang Woo Kim, Sook Young Jeon, Bomina Paik, Jun Woo Bong, Sang Hyun Kim, Suk-Hwan Lee; Ann Coloproctol. 2020;36(3):163-171. Published online February 14, 2020; DOI: https://doi.org/10.3393/ac.2019.07.20

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Abstract PDF

Purpose
To delineate the learning curve (LC) for laparoscopic appendectomy (LA) performed by residents according to seniority in training.
Methods
Between October 2015 and November 2016, 150 patients underwent LA by three residents (in their first, second, and third year of training) under supervision. The patients were non-randomly assigned to each resident. The data were reviewed and analyzed retrospectively from prospectively collected database. The perioperative outcomes were compared between the three residents including operation time, complication, conversion, and so on. The LCs were evaluated by the moving average method and cumulative sum control chart (CUSUM) for operation time and surgical completion.
Results
Baseline characteristics and perioperative outcomes were similar except for age and location of the appendix among the three groups. Operation time was not different among the three residents (43.9, 45.3, and 48.4 min for A, B, and C, respectively). The moving average method for operation time showed a decreasing tendency for all residents. CUSUM for operation time showed that the peak points occurred at the 24th, 18th, and 31st cases for resident A, B, and C, respectively. In terms of surgical failure, residents A, B, and C reached steady states after the 35th, 11th, and 16th cases, respectively. Perforation of the appendix base was the only risk factor for surgical failure.
Conclusion
The LC for LA by residents was 11-35 cases according to multidimensional statistical analyses. The accumulation of surgical experience of residents might affect the LC, especially for surgical completion rather than for operation time.

Citations

Citations to this article as recorded by

Systematic review and meta-analysis comparing perioperative outcomes of emergency appendectomy performed by trainee vs trained surgeon
Theophilus TK. Anyomih, Thomas Jennings, Alok Mehta, J Robert O'Neill, Ioanna Panagiotopoulou, Stavros Gourgiotis, Elizabeth Tweedle, John Bennett, R Justin Davies, Constantinos Simillis
The American Journal of Surgery.2023; 225(1): 168. CrossRef
Graded operative autonomy in emergency appendectomy mirrors case-complexity: surgical training insights from the SnapAppy prospective observational study
Nathalie Young, Rebecka Ahl Hulme, Maximilian Peter Forssten, Lewis Jay Kaplan, Thomas Noel Walsh, Yang Cao, Shahin Mohseni, Gary Alan Bass, Alan Biloslavo, Hayato Kurihara, Isidro Martinez-Casas, Jorge Pereira, Arvid Pourlotfi, Éanna J. Ryan, Matti Tolon
European Journal of Trauma and Emergency Surgery.2023; 49(1): 33. CrossRef
Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper
Nicola de’Angelis, Francesco Marchegiani, Carlo Alberto Schena, Jim Khan, Vanni Agnoletti, Luca Ansaloni, Ana Gabriela Barría Rodríguez, Paolo Pietro Bianchi, Walter Biffl, Francesca Bravi, Graziano Ceccarelli, Marco Ceresoli, Osvaldo Chiara, Mircea Chiri
World Journal of Emergency Surgery.2023;[Epub] CrossRef
How does the number of training years in pediatric surgery affect appendectomy outcomes?
Carlos Delgado-Miguel, Miriam Miguel-Ferrero, María San Basilio, Carla Ramírez, Juan Camps, Francisco Hernández Oliveros
Pediatric Surgery International.2023;[Epub] CrossRef
Clinical outcomes of locking polymeric clip for laparoscopic appendectomy in patients with appendicitis: a retrospective comparison with loop ligature
Seokwon Kim, Byong Ho Jeon, Sang Sik Cho, Ui Sup Shin, Sun Mi Moon
Annals of Coloproctology.2022; 38(2): 160. CrossRef
Laparoscopic appendicectomy without the use of disposable materials - a low-cost alternative - 1,552 cases operated in 20 years
CARLOS EDUARDO DOMENE, PAULA VOLPE, ANDRÉ VALENTE SANTANA
Revista do Colégio Brasileiro de Cirurgiões.2022;[Epub] CrossRef
Learning curve in laparoscopic appendectomy: training strategy of laparoscopic surgery
Hyung Ook Kim
Annals of Coloproctology.2022; 38(3): 276. CrossRef
Factors Influencing the Difficulty and Need for External Help during Laparoscopic Appendectomy: Analysis of 485 Procedures from the Resident-1 Multicentre Trial
Stefano Cioffi, Andrea Spota, Michele Altomare, Stefano Granieri, Roberto Bini, Francesco Virdis, Federica Renzi, Elisa Reitano, Osvaldo Chiara, Stefania Cimbanassi
Journal of Personalized Medicine.2022; 12(11): 1904. CrossRef
Impact of COVID-19 on the care of acute appendicitis: a single-center experience in Korea
Chang Woo Kim, Suk-Hwan Lee
Annals of Surgical Treatment and Research.2021; 101(4): 240. CrossRef

Outcomes of a Single-Port Laparoscopic Appendectomy Using a Glove Port With a Percutaneous Organ-Holding Device and Commercially-Available Multichannel Single-Port Device: Jieun Lee, Sung Ryol Lee, Hyung Ook Kim, Byung Ho Son, Wonjun Choi; Ann Coloproctol. 2014;30(1):42-46. Published online February 28, 2014; DOI: https://doi.org/10.3393/ac.2014.30.1.42

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Abstract PDF

Purpose

A laparoscopic appendectomy is now commonly performed. The push in recent years toward reducing the number of ports required to perform this surgery has led to the development of a single-port laparoscopic appendectomy (SPA). We compared postoperative pain after an SPA using a glove port with a percutaneous organ-holding device (group 1) with that of an SPA using a commercially-available multichannel single-port device (group 2).

Methods

Between March 2010 and July 2011, a retrospective study was conducted of a total of 77 patients who underwent an SPA by three surgeons at department of surgery, Kangbuk Samsung Medical Center. Thirty-eight patients received an SPA using a glove port with a percutaneous organ-holding device. The other 39 patients received an SPA using a commercially-available multichannel single port (Octo-Port or SILS Port). Operative details and postoperative outcomes were collected and evaluated.

Results

There were no differences in the mean operative times, times to pass gas, postoperative hospital stays, or cosmetic satisfaction scores between the two groups. The pain score in the first 24 hours after surgery was higher in group 2 than group 1 patients (P < 0.001). Furthermore, the trocar used in group 2 was more expensive than that used in group 1.

Conclusion

An SPA using a glove port with a percutaneous organ-holding device was associated with a lower pain score during the first 24 hours after surgery because of the shorter fascia incision length and a cheaper cost than an SPA using a commercially-available multichannel single-port device.

Citations

Citations to this article as recorded by

Single port surgery in pediatric age: report of first 300 cases
Nicola ZAMPIERI, Elettra VESTRI, Federica BIANCHI, Marta PERETTI, Simone PATANÈ, Mariangela CECCHETTO, Alberto MANTOVANI, Annamaria GIAMBANCO, Fabiana FARINA, Gabriella SCIRÈ, Francesco S. CAMOGLIO
Minerva Surgery.2023;[Epub] CrossRef
A brief overview of single-port laparoscopic appendectomy as an optimal surgical procedure for patients with acute appendicitis: still a long way to go
Yang Chen, Zongqi Fan, Xiaoxin Zhang, Xinao Fu, Jushang Li, Jieqing Yuan, Shigang Guo
Journal of International Medical Research.2023;[Epub] CrossRef
Laparoscopic Appendectomy Using the Surgical-Glove Port Through an Umbilical Incision: A Single-Center Retrospective Study
Tran Que Son, Tran Hieu Hoc, Vu Duc Long, Tran Thanh Tung, Nguyen Minh Tuan, Bui Minh Hue, Nguyen Van Minh, Nguyen Toan Thang
Cureus.2022;[Epub] CrossRef
The use of expanding ports in laparo-endoscopic single-site surgery may cause more pain: a meta-analysis of randomized clinical trials
Jannie Dressler, Lars N. Jorgensen
Surgical Endoscopy.2017; 31(11): 4400. CrossRef
Two-port laparoscopic anterior resection through a self-made glove device versus conventional laparoscopic anterior resection for rectal cancer: a comparison of short-term surgical results
Hong Zhang, Yunzhi Ling, Jinchun Cong, Mingming Cui, Dingsheng Liu, Chunsheng Chen
World Journal of Surgical Oncology.2016;[Epub] CrossRef
The learning curve of single-port laparoscopic appendectomy performed by emergent operation
YongHun Kim, WooSurng Lee
World Journal of Emergency Surgery.2016;[Epub] CrossRef
Needlescopic-Assisted Surgery: Single-Incision or Multi-Incision Laparoscopic Surgery?
Chang-Nam Kim
Annals of Coloproctology.2014; 30(1): 9. CrossRef

A Clinical Comparison of Laparoscopic versus Open Appendectomy for Complicated Appendicitis: Sun Gu Lim, Eun Jung Ahn, Seong Yup Kim, Il Yong Chung, Jong-Min Park, Sei Hyeog Park, Kyoung Woo Choi; J Korean Soc Coloproctol. 2011;27(6):293-297. Published online December 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.6.293

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Abstract PDF

Purpose

Although laparoscopic appendectomies (LAs) are performed universally, a controversy still exists whether the LA is an appropriate surgical approach to complicated appendicitis (CA). We retrospectively evaluated the outcomes of laparoscopic versus open appendectomies for CA.

Methods

We retrospectively analyzed 60 consecutive patients who were diagnosed as having CA from July 2009 to January 2011. Outcomes such as operative time, time to soft diet, length of hospital stay, and postoperative complications were analyzed.

Results

There were no statistically significant differences in operative time between the LA and the open appendectomy (OA) groups. Return to soft diet was faster in the LA group (2.1 ± 1.2 vs. 3.5 ± 1.5 days; P = 0.001). Length of hospital stay was shorter for the LA group (4.4 ± 2.3 vs. 5.8 ± 2.9 days; P = 0.045). The overall complication rates showed no statistically significant difference between the two groups. In cases involving a periappendiceal abscess, the LA had a significantly higher incidence of intra-abdominal abscess (IAA) and postoperative ileus (PI; P = 0.028).

Conclusion

The LA showed good results in terms of the time to soft diet, the length of hospital stay, and surgical site infection (SSI) whereas the overall complication rates were similar for the two groups. However, the LA was associated with significantly higher incidence of IAA and PI for the cases with a periappendiceal abscess. Therefore, when using a LA, the surgeon must take great care to minimize the incidence of IAA and PI if a periappendiceal abscess is present.

Citations

Citations to this article as recorded by

Risk factors for developing intra-abdominal abscess following appendicectomy for acute appendicitis: a retrospective cohort study
B P Mao, G Collins, F E Ayeni, D J Vagg
Langenbeck's Archives of Surgery.2024;[Epub] CrossRef
The outcomes of laparoscopic versus open appendectomies for complicated appendicitis
Ahmed A. Sabry, Mahmoud Menesy, Mohamed Kassem, Mostafa R. Elkeleny
The Egyptian Journal of Surgery.2023; 42(3): 736. CrossRef
Intra and Postoperative Advantages of Laparoscopy in the Treatment of Complicated Appendicitis
Andrej Nikolovski, Cemal Ulusoy
PRILOZI.2022; 43(2): 59. CrossRef
AAn Evaluation of the Choice of the Treatment for the Acute Appendicitis An Original Research
Srikanth N. Jarupla, Ganesh Vadthya, Mushtaq A. Chowdhary, Heena D. Tiwari, Pritee R. Pandey, Afroz K. Syed, Akriti Mahajan
Journal of Pharmacy and Bioallied Sciences.2022; 14(Suppl 1): S188. CrossRef
Predictors for prolonged length of stay after laparoscopic appendectomy for complicated acute appendicitis in adults
Aleix Martínez-Pérez, Carmen Payá-Llorente, Sandra Santarrufina-Martínez, Juan Carlos Sebastián-Tomás, Elías Martínez-López, Nicola de’Angelis
Surgical Endoscopy.2021; 35(7): 3628. CrossRef
A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study
Tomoya Takami, Tomoyuki Yamaguchi, Hiroyuki Yoshitake, Kotaro Hatano, Naoki Kataoka, Masafumi Tomita, Shinichiro Makimoto
European Journal of Trauma and Emergency Surgery.2020; 46(4): 847. CrossRef
Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial
Ahmed Talha, Hany El-Haddad, Abd-Elhamid Ghazal, Gihan Shehata
Surgical Endoscopy.2020; 34(2): 907. CrossRef
The Bucharest ESTES consensus statement on peritonitis
Bogdan Diaconescu, Selman Uranues, Abe Fingerhut, Mihaela Vartic, Mauro Zago, Hayato Kurihara, Rifat Latifi, Dorin Popa, Ari Leppäniemi, Jonathan Tilsed, Matei Bratu, Mircea Beuran
European Journal of Trauma and Emergency Surgery.2020; 46(5): 1005. CrossRef
Complications after Laparoscopic Appendectomy for Complicated Appendicitis
Andrej Nikolovski, Shenol Tahir, Dragoslav Mladenovikj
Lietuvos chirurgija.2020; 19(1-2): 34. CrossRef
Irrigation Versus Suction in Laparoscopic Appendectomy for Complicated Appendicitis: A Meta-analysis
Charalampos Siotos, Konstantinos Stergios, Vishnu Prasath, Stella M. Seal, Mark D. Duncan, Joseph V. Sakran, Mehran Habibi
Journal of Surgical Research.2019; 235: 237. CrossRef
Laparoscopic appendicectomy is superior to open surgery for complicated appendicitis
Gaik S. Quah, Guy D. Eslick, Michael R. Cox
Surgical Endoscopy.2019; 33(7): 2072. CrossRef
Comparison of clinical outcome of laparoscopic versus open appendectomy, single center experience
Mitsugi Shimoda, Tsunehiko Maruyama, Kiyotaka Nishida, Kazuomi Suzuki, Tomoya Tago, Jiro Shimazaki, Shuji Suzuki
Heliyon.2018; 4(5): e00635. CrossRef
Systematic Review and Meta‐Analysis of Laparoscopic Versus Open Appendicectomy in Adults with Complicated Appendicitis: an Update of the Literature
Christos Athanasiou, Sonia Lockwood, Georgios A. Markides
World Journal of Surgery.2017; 41(12): 3083. CrossRef
Comparison of clinical outcome of laparoscopic versus open appendectomy for complicated appendicitis
P. Horvath, J. Lange, R. Bachmann, F. Struller, A. Königsrainer, M. Zdichavsky
Surgical Endoscopy.2017; 31(1): 199. CrossRef
Laparoscopic Appendectomy Using Hem-o-lok Polymer Clips: A Single-Center Experience
Bahadır Öz, Ertan Emek, Muhammet Akyüz, Erdoğan Sözüer, Türkmen Arıkan, Alper Akcan, Hızır Akyıldız
International Surgery.2017; 102(7-8): 334. CrossRef
Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections
Charles Hoffmann, Matthew Zak, Lisa Avery, Jack Brown
Antibiotics.2016; 5(1): 11. CrossRef
Laparoscopic versus open surgery for complicated appendicitis in adults: a randomized controlled trial
Yoshiro Taguchi, Shunichiro Komatsu, Eiji Sakamoto, Shinji Norimizu, Yuji Shingu, Hiroshi Hasegawa
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Laparoscopic versus open approach in the management of appendicitis complicated exclusively with peritonitis: A single center experience
Felipe Quezada, Nicolas Quezada, Ricardo Mejia, Alejandro Brañes, Oslando Padilla, Nicolas Jarufe, Fernando Pimentel
International Journal of Surgery.2015; 13: 80. CrossRef
Are There Specific Indications for Laparoscopic Appendectomy? A Review and Critical Appraisal of the Literature
Dorin Popa, Marek Soltes, Selman Uranues, Abe Fingerhut
Journal of Laparoendoscopic & Advanced Surgical Techniques.2015; 25(11): 897. CrossRef
Is laparoscopy a safe approach for diffuse appendicular peritonitis? Feasibility and determination of risk factors for post-operative intra-abdominal abscess
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Same-day Surgery for Laparoscopic Appendectomy in Appendicitis: Is this Safe?
Wirt Cross, Gopal Chandru Kowdley
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Comparison of Clinical Outcomes after Laparoscopic and Open Appendectomy for Complicated Appendicitis
Jong Min Kim, Sung Ryol Lee, Hyung Ook Kim, Won Joon Choi, Byung Ho Son
The Journal of Minimally Invasive Surgery.2013; 16(4): 98. CrossRef
A Study of Laparoscopic Appendectomy
Yo MIZUKAMI, Shuichi OTA, Atsushi HARADA, Masatoshi AKAGAMI, Takuya INOMOTO, Yukito ADACHI
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2013; 74(6): 1423. CrossRef

Efficacy of a Laparoscopic Appendectomy When Performed by Surgeons Early in Their Laparoscopic Training Courses.: Joo, Kyu Hwa , Son, Byung Ho , Kim, Hyung Ook , Hwang, Sang Il , Kim, HungDai , Han, Won Kon; J Korean Soc Coloproctol. 2010;26(1):17-21.; DOI: https://doi.org/10.3393/jksc.2010.26.1.17

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Abstract PDF

PURPOSE
Laparoscopic surgery has many advantages and has been a popular method for the treatment of various diseases. Although a laparoscopic appendectomy (LA) is now a common practice, it has not yet become the treatment of choice for appendicitis of inexperienced surgeons in their early days of individual laparoscopic training courses. The purpose of this study was to compare the results obtained by inexperienced surgeons to those obtained by experienced surgeons.
METHODS
From May 2007 to January 2008, 130 patients underwent a LA at our department. The surgeries were performed by three surgeons. The patients were divided into 2 groups. In Group I, the LAs were performed by one surgeon who was experienced with laparoscopic procedures, and in Group II, the LAs were performed by two surgeons who were relatively inexperienced with laparoscopic procedures. We retrospectively reviewed patient's medical records for age, sex, previous abdomen operation history, operation method, operation time, surgical complications, length of hospital stay, and the time to resume soft diet.
RESULTS
The age was younger in Group I (29.8+/-18.2 vs. 36.0+/-16.0 yr, P=0.041). The operation time was longer in Group II (48.4+/-28.7 vs. 64.1+/-30.0 min, P=0.003). In Group I, wound infections developed in 4 cases. In Group II, wound infections developed in 7 cases, and an intraabdominal abscess developed in 1 case. The differences in conversion rates, times to start of diet, uses of analgesics, and hospital stays were not statistically significant.
CONCLUSION
Even though an inexperienced surgeon performs the LA for acute appendicitis, there are no differences in postoperative complications and returns to daily activities compared to a LA performed for acute appendicitis by an experienced surgeon. LA is a safe method for the treatment of acute appendicitis for surgeons who are new to laparoscopic procedures.

Citations

Citations to this article as recorded by

Learning curve in laparoscopic appendectomy: training strategy of laparoscopic surgery
Hyung Ook Kim
Annals of Coloproctology.2022; 38(3): 276. CrossRef
A Clinical Comparison of Laparoscopic versus Open Appendectomy for Complicated Appendicitis
Sun Gu Lim, Eun Jung Ahn, Seong Yup Kim, Il Yong Chung, Jong-Min Park, Sei Hyeog Park, Kyoung Woo Choi
Journal of the Korean Society of Coloproctology.2011; 27(6): 293. CrossRef

The Initial Experience with a Single Incision Laparoscopic Appendectomy.: Kim, Jong Won , Park, Jun Seok , Chang, In Taik , Choi, Yoo Shin , Song, Hyung Jun , Kim, Beom Gyu; J Korean Soc Coloproctol. 2009;25(5):312-317.; DOI: https://doi.org/10.3393/jksc.2009.25.5.312

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Abstract PDF

PURPOSE
A laparoscopic appendectomy (LA) is becoming popular for the treatment of acute and perforated appendicitis. Since it was first described, the LA has been modified many times. We present the result for a new technique of LA, in which the LA is conducted through a single umbilical incision without exteriorizing the appendix to perform the operation.
METHODS
A single incision laparoscopic appendectomy was attempted in 25 patients (17 men, 8 women). Under general anesthesia, a wound retractor was inserted through the umbilicus. The appendix was grasped and dissected from surrounding tissues with a single flexible dissector or grasper. After mesenteric dissection with ultrasonic shear, the base of the appendix was ligated with an Endoloop. The appendix was withdrawn into the wound protector and extracted from the abdomen.
RESULTS
A single incision laparoscopic appendectomy was completed in 25 patients. No major intraoperative or postoperative complications were encountered. The average duration of the procedure was 50.3+/-21.3 min. The average hospital stay was 4.1+/-2.4 days.
CONCLUSION
This new technique, a single incision laparoscopic appendectomy, further improves the minimal invasiveness of a LA because a single incision is used. This procedure is a safe, very minimally invasive procedure with excellent cosmetic results.

Citations

Citations to this article as recorded by

Single-incision versus conventional multi-incision laparoscopic appendicectomy for suspected uncomplicated appendicitis
Ahmer Irfan, Ahsan Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2024;[Epub] CrossRef
Comparative Study of a Single-Incision Laparoscopic and a Conventional Laparoscopic Appendectomy for the Treatment of Acute Appendicitis
Jungwoo Kang, Byung Noe Bae, Geumhee Gwak, Inseok Park, Hyunjin Cho, Keunho Yang, Ki Whan Kim, Sehwan Han, Hong-Joo Kim, Young-Duck Kim
Journal of the Korean Society of Coloproctology.2012; 28(6): 304. CrossRef
What Are the Risk Factors for Complication in Transumbilical Single-Port Appendectomy?
Hee Sung Lee, Yong Hae Baik, In Woong Han, Won Yong Choi, Beom Seok Kwak, Young Jin Park, Min Gu Oh, Hong Yong Kim
The Journal of Minimally Invasive Surgery.2012; 15(4): 138. CrossRef
A Review of Minimally Invasive Single-Port/Incision Laparoscopic Appendectomy
Haroon Rehman, Tim Mathews, Irfan Ahmed
Journal of Laparoendoscopic & Advanced Surgical Techniques.2012; 22(7): 641. CrossRef
Single-incision Appendectomy is Comparable to Conventional Laparoscopic Appendectomy
Richdeep S. Gill, Xinzhe Shi, David P. Al-Adra, Daniel W. Birch, Shahzeer Karmali
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2012; 22(4): 319. CrossRef
Single incision versus conventional multi-incision appendicectomy for suspected appendicitis
Haroon Rehman, Ahsan M Rao, Irfan Ahmed
Cochrane Database of Systematic Reviews.2011;[Epub] CrossRef
Technical approaches to single port/incision laparoscopic appendicectomy: a literature review
H Rehman, I Ahmed
The Annals of The Royal College of Surgeons of England.2011; 93(7): 508. CrossRef
Laparoscopic Appendectomy with a Single Incision in a Single Institute
Jin A Lee, Ki Young Sung, Jun Hyun Lee, Do Sang Lee
Journal of the Korean Society of Coloproctology.2010; 26(4): 260. CrossRef

Case Report

Laparoscopic Appendectomy for Acute Appendicitis Caused by Enterobius Vermicularis.: Lee, Yoon suk , Lee, In kyu , Oh, Seung teak , Kim, Jun gi , Jang, Suk kyun , Kim, Young ha , Kim, Kyung Mee; J Korean Soc Coloproctol. 2005;21(4):255-257.

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Abstract PDF: Enterobius vermicularis (pinworm) infection occurs in 4~28% worldwide. Although the most common clinical manifestation is perianal pruritis, it may cause gastrointestinal manifestations, including acute appendicitis in about 0.2~41.8% of infections. Preoperative diagnosis of pinworms in patients with acute appendicitis is not routinely performed. We performed a laparoscopic appendectomy for an acute appendicitis caused by Enterobius vermicularis. To our knowledge, this is the first report of a laparoscopic appendectomy for acute appendicitis caused by Enterobius vermicularis in Korea.

Original Articles

Clinical Evaluation of Laparoscopic Appendectomy.: Lee, Min Hwa , Song, Byung Joo , Choi, Sang Yong , Park, Sin Hee , Kim, Chin Seung; J Korean Soc Coloproctol. 1998;14(3):551-560.

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Abstract PDF: BACKGROUND
This study was performed to evaluate our experience on laparoscopic appendectomy.
METHODS
Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998.
RESULTS
Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order.
CONCLUSION
Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.

Clinical Usefulness of Laparoscopic Appendectomy.: Shin, Jun Ho , Park, Yong Kai , Kim, Heung Dae; J Korean Soc Coloproctol. 1998;14(3):541-550.

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Abstract PDF: PURPOSE
There have been numerous retrospective and uncontrolled study of laparoscopic appendectomy. Although most of these have concluded that the laparoscopic appendectomy is at least as good as open appendectomy, there has been considerable controversy as to whether laparoscopic appendectomy is superior.
METHODS
We performed total 47 cases of laparoscopic appendectomy (LA) during one year from January 1997 to December 1997 and these were compared with 50 cases of open appendectomy (OA) in same period to assess the clinical usefulness.
RESULTS
The sex, male to female ratio and severity of appendicitis were similar in both groups. The anesthetic time was longer in the LA group (P<0.05) but operative time was similar. Gas-passing time and diet-intake time in postoperative period were earlier in LA group (P<0.05). The LA group required less analgesics in postoperative period. In LA group, no case was converted to open appendectomy and overall complication rate was lower in LA group but this was not statistically significant. Among the postoperative complication, the wound infection rate was absolutely lower in LA group (P<0.05). The diagnostic rate for acute abdomen including acute appendicitis was superior in LA group, especially in reproductive women. The hospital stay was shorter in LA group (P<0.05) and hospital charges was not different in both group.
CONCLUSION
Laparoscopic appendectomy offers considerable advantages over open appendectomy because this has ability to reduce postoperative complications and shorten recovery times and is useful for detecting the cause of acute abdomen other than acute appendicitis. So we expect this technique will be alternative operation or new standard operation in selected cases for suggestive acute appendicitis.

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