Initial experience in laparoscopic single-port appendectomy: a pilot study.

Background: We describe our initial experience performing a single-port (SP) advanced laparoscopic appendectomy in comparison to the conventional port (CP) technique, which uses three ports.

Methods: Between June and September 2009, 40 consecutive patients with acute appendicitis underwent laparoscopic appendectomy at Vivantes Klinikum Am Urban, Berlin, Germany. Twenty patients were operated on using the SP technique (SP group), and the data were compared to a control group of 20 patients operated on using the CP technique (CP group) during the same time period.

Results: SP surgery was successfully performed on all patients without conversion to CP laparoscopic appendectomy or an open procedure. The mean age was 27.7 ± 8.3 years in the SP group and 31.7 ± 9.3 in the CP group (p = 0.32). Gender (p = 0.352), status of the American Society of Anesthesiologists (p = 0.765) and body mass index (p = 0.971) did not differ significantly between the two groups. The mean operating time was 48.0 ± 13.2 min in the SP group versus 49.0 ± 19.9 min in the CP group (p = 0.694). No patient in the SP group developed surgical complications. No patient in either group developed an incisional hernia or wound infection during the mean follow-up of 98.17 ± 38.56 days.

Conclusion: Transumbilical SP appendectomy via a tri-port system with a single incision is a feasible and safe new approach for routine appendectomy. It is easy to perform and good training for more advanced SP surgery.