Solo Single-Incision Laparoscopic Appendectomy versus Conventional Single-Incision Laparoscopic Appendectomy: A Retrospective, Single Center Study

ABSTRACT

PURPOSE: Single incision laparoscopic appendectomy (SILA) attempts to advance laparoscopic appendectomy with the aim of quicker recovery, less pain, a smaller scar, and better patient satisfaction, and it might offer better outcomes than conventional laparoscopic appendectomy. However, conventional SILA (C-SILA) is not widely practiced. C-SILA is associated with several ergonomic challenges when compared with standard multiport laparoscopy owing to the handling of straight instruments in parallel with a camera. The aim of this retrospective study was to review and compare the outcomes of SILA performed by residents in solo approach and a conventional non-solo approach in order to determine whether S-SILA can be performed effectively by residents. METHODS: Between March 2016 and February 2018, at SNUBH, 87 patients underwent SILA performed by residents, and of these patients, 36 underwent S-SILA and 51 underwent C-SILA. RESULTS: Patient characteristics and severities of appendicitis were different between the S-SILA and C-SILA groups. Although cases were more complicated in the S-SILA group, the surgical outcomes were similar between the S-SILA and C-SILA groups. These findings suggest that S-SILA can be a reasonable alternative to C-SILA for surgeons who can competently perform SILA. CONCLUSION: The surgical outcomes were similar between S-SILA and C-SILA. Moreover, S-SILA could reduce the number of required personnel, resulting in a reduction in healthcare cost. S-SILA can be considered a reasonable alternative to C-SILA for surgeons who can competently perform SILA.