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Randomized Prospective Study to Compare Laparoscopic Appendectomy Versus Umbilical Single-Incision Appendectomy

Frutos, Ma Dolores MD, PhD; Abrisqueta, Jesus MD; Lujan, Juan MD, PhD; Abellan, Israel MD; Parrilla, Pascual MD, PhD

doi: 10.1097/SLA.0b013e318278d225
Randomized Clinical Trials

Introduction: The use of single-incision laparoscopic surgery may represent an improvement over conventional laparoscopic surgery. In recent years, more and more articles have been published demonstrating the feasibility of this approach. Hence, for this reason, we present this randomized prospective study to compare the 2 techniques.

Methods: Between September 2009 and December 2010, a total of 184 patients with a diagnosis of acute appendicitis and indicated for surgery were included in the study, of whom, 91 received an appendectomy via a single umbilical incision and 93 via conventional laparoscopy. The study protocol was approved by the ethical committee of the Virgen de la Arrixaca University Hospital (Murcia). The study was registered on ClinicalTrials.gov with inscription number NCT0151529. All the operations were performed by the same team of surgeons.

Results: As far as the demographical results of the study population are concerned, there were no significant differences between the 2 groups for age, weight, sex, body mass index, and removed appendix type. Operating time was longer with the single-port approach: 38.13 ± 13.49 versus 32.12 ± 12.44 minutes (P = 0.02). Significant differences were observed for postoperative pain, which was measured on the visual analog scale, with less pain reported in the single-incision group: 2.76 ± 1.64 versus 3.78 ± 1.76 (P < 0.001). There were no significant differences between the 2 groups for early and late complications and lengths of hospital stay measured in postoperative hours.

Conclusions: The transumbilical single-port approach is seen as a feasible technique for performing appendectomy. It does not increase the rate of complications and represents a possible alternative to conventional laparoscopic appendectomy.

We present a randomized prospective study comparing single-incision laparoscopic appendectomy with laparoscopic appendectomy. There were no significant differences between the 2 groups for early and late complications. Single-incision laparoscopic surgery represents a possible alternative to conventional laparoscopic appendectomy.

From the Servicio de Cirugía General y Digestivo, Hospital Universitario “Virgen de la Arrixaca,” CIBERehd, Murcia, Spain.

Reprints: M Dolores Frutos, MD, PhD, Servicio de Cirugía General y Digestivo, Hospital Universitario “Virgen de la Arrixaca,” CIBERehd, 30120 El Palmar, Murcia, Spain. E-mail: doloresfrutos@yahoo.es.

Disclosure: The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.