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Eur J Pediatr Surg 2012; 22(03): 201-206
DOI: 10.1055/s-0032-1320015
Review
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Minimally Invasive Approach to Appendectomy: Is Less Better?

Corey W. Iqbal
1   The Children's Mercy Hospital, Kansas City, Missouri, United States
,
Daniel J. Ostlie
1   The Children's Mercy Hospital, Kansas City, Missouri, United States
› Author Affiliations
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Publication History

Publication Date:
05 July 2012 (online)

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Abstract

The benefits of the three-port laparoscopic appendectomy (TPLA) are now appreciated. Included in these advantages are reduced postoperative pain, reduced hospitalization, early return to routine activities, and a definite cosmetic benefit over the open approach. Recently, the single-incision laparoscopic technique for several disease processes has been popularized. The single-incision approach through the umbilicus is ideally suited for patients with nonperforated appendicitis. This article will review our operative technique for both the TPLA and single-incision laparoscopic appendectomy, and then review the available literature that compares benefits of one approach over the other. When comparing these two approaches, variables that will be discussed include infectious complications, operative time and cost, and the need for postoperative pain medication.

Keywords

appendectomy - appendicitis - laparoscopy - single-incision laparoscopic appendectomy - pediatric literature
 

  • References

  • 1 Semm K. Endoscopic appendectomy. Endoscopy 1983; 15 (2) 59-64
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2004; 18: CD001546
    PubMedSearch in Google Scholar
  • 3 Temple LK, Litwin DE, McLeod RS. A meta-analysis of laparoscopic versus open appendectomy in patients suspected of having acute appendicitis. Can J Surg 1999; 42 (5) 377-383
    PubMedSearch in Google Scholar
  • 4 Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a metaanalysis. J Am Coll Surg 1998; 186 (5) 545-553
    CrossrefPubMedSearch in Google Scholar
  • 5 Wang X, Zhang W, Yang X, Shao J, Zhou X, Yuan J. Complicated appendicitis in children: is laparoscopic appendectomy appropriate? A comparative study with the open appendectomy—our experience. J Pediatr Surg 2009; 44 (10) 1924-1927
    CrossrefPubMedSearch in Google Scholar
  • 6 Esposito C, Borzi P, Valla JS , et al. Laparoscopic versus open appendectomy in children: a retrospective comparative study of 2,332 cases. World J Surg 2007; 31 (4) 750-755
    CrossrefPubMedSearch in Google Scholar
  • 7 Aziz O, Athanasiou T, Tekkis PP , et al. Laparoscopic versus open appendectomy in children: a meta-analysis. Ann Surg 2006; 243 (1) 17-27
    CrossrefPubMedSearch in Google Scholar
  • 8 Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R. Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg 2005; 242 (3) 439-448 , discussion 448–450
    CrossrefPubMedSearch in Google Scholar
  • 9 Olmi S, Magnone S, Bertolini A, Croce E. Laparoscopic versus open appendectomy in acute appendicitis: a randomized prospective study. Surg Endosc 2005; 19 (9) 1193-1195
    CrossrefPubMedSearch in Google Scholar
  • 10 Moberg AC, Berndsen F, Palmquist I, Petersson U, Resch T, Montgomery A. Randomized clinical trial of laparoscopic versus open appendicectomy for confirmed appendicitis. Br J Surg 2005; 92 (3) 298-304
    CrossrefPubMedSearch in Google Scholar
  • 11 Guller U, Hervey S, Purves H , et al. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Ann Surg 2004; 239 (1) 43-52
    CrossrefPubMedSearch in Google Scholar
  • 12 Alkhoury F, Burnweit C, Malvezzi L , et al. A prospective study of safety and satisfaction with same-day discharge after laparoscopic appendectomy for acute appendicitis. J Pediatr Surg 2012; 47 (2) 313-316
    CrossrefPubMedSearch in Google Scholar
  • 13 de Kok HJ. A new technique for resecting the non-inflamed not-adhesive appendix through a mini-laparotomy with the aid of the laparoscope. Arch Chir Neerl 1977; 29 (3) 195-198
    PubMedSearch in Google Scholar
  • 14 Vettoretto N, Mandalà V. Single port laparoscopic appendectomy: are we pursuing real advantages?. World J Emerg Surg 2011; 6: 25
    CrossrefPubMedSearch in Google Scholar
  • 15 St Peter SD, Adibe OO, Juang D , et al. Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg 2011; 254 (4) 586-590
    CrossrefPubMedSearch in Google Scholar
  • 16 Kang DB, Lee SH, Lee SY , et al. Application of single incision laparoscopic surgery for appendectomy in children. J Korean Surg Soc 2012; 82 (2) 110-115
    CrossrefPubMedSearch in Google Scholar
  • 17 Park J, Kwak H, Kim SG, Lee S. Single-port laparoscopic appendectomy: comparison with conventional laparoscopic appendectomy. J Laparoendosc Adv Surg Tech A 2012; 22 (2) 142-145
    CrossrefPubMedSearch in Google Scholar
  • 18 Colon MJ, Telem D, Divino CM, Chin EH. Laparoendoscopic single site surgery can be performed completely with standard equipment. Surg Laparosc Endosc Percutan Tech 2011; 21 (4) 292-294
    CrossrefPubMedSearch in Google Scholar
  • 19 Muensterer OJ, Keijzer R. A simple vacuum dressing reduces the wound infection rate of single-incision pediatric endosurgical appendectomy. JSLS 2011; 15 (2) 147-150
    CrossrefPubMedSearch in Google Scholar
  • 20 Ostlie DJ. Single-site umbilical laparoscopic appendectomy. Semin Pediatr Surg 2011; 20 (4) 196-200
    CrossrefPubMedSearch in Google Scholar
  • 21 Ohno Y, Morimura T, Hayashi S. Transumbilical laparoscopically assisted appendectomy in children: the results of a single-port, single-channel procedure. Surg Endosc 2012; 26 (2) 523-527
    CrossrefPubMedSearch in Google Scholar
  • 22 Petnehazy T, Saxena AK, Ainoedhofer H, Hoellwarth ME, Schalamon J. Single-port appendectomy in obese children: an optimal alternative?. Acta Paediatr 2010; 99 (9) 1370-1373
    CrossrefPubMedSearch in Google Scholar
  • 23 Teoh AY, Chiu PW, Wong TC, Wong SK, Lai PB, Ng EK. A case-controlled comparison of single-site access versus conventional three-port laparoscopic appendectomy. Surg Endosc 2011; 25 (5) 1415-1419
    CrossrefPubMedSearch in Google Scholar
  • 24 Chandler NM, Danielson PD. Single-incision laparoscopic appendectomy vs multiport laparoscopic appendectomy in children: a retrospective comparison. J Pediatr Surg 2010; 45 (11) 2186-2190
    CrossrefPubMedSearch in Google Scholar
  • 25 Goel R, Buhari SA, Foo J , et al. Single-incision laparoscopic appendectomy: prospective case series at a single centre in Singapore. Surg Laparosc Endosc Percutan Tech 2011; 21 (5) 318-321
    CrossrefPubMedSearch in Google Scholar
  • 26 St Peter SD, Ostlie DJ. The necessity for prospective evidence for single-site umbilical laparoscopic surgery. Semin Pediatr Surg 2011; 20 (4) 232-236
    CrossrefPubMedSearch in Google Scholar
  • 27 Hayashi M, Asakuma M, Komeda K, Miyamoto Y, Hirokawa F, Tanigawa N. Effectiveness of a surgical glove port for single port surgery. World J Surg 2010; 34 (10) 2487-2489
    CrossrefPubMedSearch in Google Scholar
  • 28 Mayer S, Werner A, Wachowiak R , et al. Single-incision multiport laparoscopy does not cause more pain than conventional laparoscopy: a prospective evaluation in children undergoing appendectomy. J Laparoendosc Adv Surg Tech A 2011; 21 (8) 753-756
    CrossrefPubMedSearch in Google Scholar
  • 29 Lee SW, Milsom JW, Nash GM. Single-incision versus multiport laparoscopic right and hand-assisted left colectomy: a case-matched comparison. Dis Colon Rectum 2011; 54 (11) 1355-1361
    CrossrefPubMedSearch in Google Scholar
  • 30 Bencsath KP, Falk G, Morris-Stiff G, Kroh M, Walsh RM, Chalikonda S. Single-incision laparoscopic cholecystectomy: do patients care?. J Gastrointest Surg 2012; 16 (3) 535-539
    CrossrefPubMedSearch in Google Scholar
  • 31 Stylianos S, Nichols L, Ventura N, Malvezzi L, Knight C, Burnweit C. The “all-in-one” appendectomy: quick, scarless, and less costly. J Pediatr Surg 2011; 46 (12) 2336-2341
    CrossrefPubMedSearch in Google Scholar
  • 32 Lee YS, Kim JH, Moon EJ , et al. Comparative study on surgical outcomes and operative costs of transumbilical single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy in adult patients. Surg Laparosc Endosc Percutan Tech 2009; 19 (6) 493-496
    CrossrefPubMedSearch in Google Scholar
  • 33 Knott EM, Gasior AC, Holcomb GW , et al. Impact of body habitus on single site laparoscopic appendectomy for nonperforated appendicitis: subset analysis from a prospective, randomized trial. J Laparoendosc Adv Surg Tech A 2012; 22 (4) 404-407
    CrossrefPubMedSearch in Google Scholar
  • 34 Sesia SB, Haecker FM, Kubiak R, Mayr J. Laparoscopy-assisted single-port appendectomy in children: is the postoperative infectious complication rate different?. J Laparoendosc Adv Surg Tech A 2010; 20 (10) 867-871
    CrossrefPubMedSearch in Google Scholar