Appendectomy is the most common abdominal emergency operation selleck screening library performed in the western world. Some reasons have made that more and more appendectomies are currently performed laparoscopically such as advantages to patients in terms of more accurate diagnosis, diminished wound infections, possibility to treat obese patients, and a more rapid recovery . First report of single-puncture laparoscopic appendectomy technique was performed in 1992 and showed the new approach as a safe, inexpensive, and effective alternative to the currently used multiple-puncture method . The new transumbilical approach seems to reduce the trauma of surgical access with its improvement of the postoperative pain and patient cosmesis compared to standard laparoscopic approach.
However, other important issues must be critically analysed such as time consumed complications, and difficulties to perform this novel technique. This new technique has been introduced to the surgical community, and we have concentrated on knowing about the feasibility, safety, and clinical advantage of the method. For these reasons, in order to implement SPA appendectomy (SPAA), and know its difficulties, limitations, or advantages, we conducted this multicentre study. The aim of the study is to know if SPA would offer similar operative time, length of stay, and complication profile with improved cosmesis and less postoperative pain in comparison to traditional multi-incision laparoscopic appendectomy or also called standard laparoscopic appendectomy (LA). 2.
Patients and Methods In this study, 92 patients (Table 1) underwent SPA appendectomy and standard laparoscopic appendectomy. Three different teams of surgeons in three different hospitals performed the interventions: Vall d’Hebron Hospital (Barcelona, Spain), Cairo University Hospital (Cairo, Egypt), and Istanbul Faculty of Medicine (Istanbul, Turkey). All the three surgeons were trained expert surgeons in laparoscopy and had already performed SILS cholecystectomy previously. All the patients were informed about the intervention technique and provided written informed consent. All the patients had a suggestive clinical diagnosis of acute appendicitis. All patients included in the study were from patients undergoing urgent surgery. Each patient in each hospital was included alternatively in each treatment group (SPAA group and LA group).
Table 1 Demographic data of the Single Port Access Appendectomy Group (SPAA Group) and the Laparoscopic Appendectomy Group (LA Group). 2.1. Operative GSK-3 Technique The two surgical techniques were established in both the study and control groups according to a consensus approved by the authors previous to the beginning of the study and according to the different hospital possibilities. Patients were divided into two different groups: SPAA group (SPAAG) and LA group (LAG).