Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children

Submitted: 1 March 2016
Accepted: 30 November 2016
Published: 20 December 2016
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Transumbilical laparoscopic assisted appendectomy combines laparoscopic single port dissection with open appendectomy after exteriorization of the appendix through the port site. Compared to the conventional three-port approach, this technique provides an alternative with excellent cosmetic outcome. We developed a safe and effective technique to perform an intracorporeal single port appendectomy, using the same laparoscope employed in the extracorporeal procedure. Retrospective review of 71 consecutively performed intracorporeal single port appendectomies and 30 conventional three-port appendectomies in children 6 to 17 years of age. A straight 10-mm Storz telescope with inbuilt 6 mm working channel is used to dissect the appendix, combined with one port-less 2.3 mm percutaneous grasper. Polymer WECK® hem-o-lock® clips are applied to seal the base of the appendix and the appendiceal vessels. No intraoperative complications were reported with the hybrid intracorporeal single port appendectomy or three-port appendectomy. There were two post-operative complications in the group treated with the single port hybrid technique: one intra-abdominal abscess and one surgical site infection. Groups did not differ in age, weight, and types of appendicitis. Operative times were shorter for the hybrid technique (70 vs 79 minutes) but did not differ significantly (P=0.19). This modified technique to a previously described single port extracorporeal appendectomy is easy to master and implement. It provides exposure similar to a three-port laparoscopic appendectomy, while maintaining virtually scarless results and potentially reduces the risk for surgical site infections compared to the extracorporeal technique.

Paul Anthony Karam, Department of Pediatric Surgery, Cleveland Clinic Foundation, Cleveland, OH

Assistant Professor of Surgery, Cleveland Clinic Lerner College of Medicine

of Case Western Reserve University

Director, Minimally Invasive Surgery and Advanced Technologies

Karam, P. A., Hiuser, A., Magnuson, D., & Seifarth, F. G. F. (2016). Intracorporeal hybrid single port vs conventional laparoscopic appendectomy in children. La Pediatria Medica E Chirurgica, 38(3).


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