scholarly journals Transumbilical Single-Incision Laparoscopic-Assisted Appendectomy (TULAA) is Useful in Adults and Young Adolescents: Comparison with Multi-Port Laparoscopic Appendectomy

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 248 ◽  
Author(s):  
Seung Gyu Jin ◽  
Seong Hoon Cho ◽  
Kwang Yong Kim ◽  
Soo Kyung Ahn ◽  
Ji Woong Hwang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Single Incision ◽  
Fluid Collection ◽  
Postoperative Hospital Stay ◽  
Young Adolescents ◽  
Extended Resection ◽  
Open Conversion ◽  
Laparoscopic Assisted

Background and objectives: Single-port laparoscopic appendectomy (SLA) in most previous studies has used intracorporeal excision of the appendix and needed a longer operative time than multi-port laparoscopic appendectomy (MLA), although SLA does have the potential benefit of an almost invisible scar within the umbilicus. Some studies have reported that extracorporeal transumbilical single-incision laparoscopic-assisted appendectomy (TULAA) in children took a considerably reduced operative time compared to MLA. We adopted TULAA in adults, adding routine dissection of the peritoneal attachment of the appendix. The aim was to compare the operative outcomes between TULAA and MLA. Materials and Methods: Between March 2013 and January 2016, 770 patients with acute uncomplicated and complicated appendicitis from 15 to 75 years of age were enrolled retrospectively. The operation was performed as early (EA) and interval appendectomy (IA). Results: Operative time was shorter in the TULAA group than in the MLA group, except for IA. No open conversion occurred in the TULAA group, except one case of ileocecal resection for IA. No intra-abdominal fluid collection was found in the TULAA group. Extended resection (especially partial cecectomy) was performed less frequently in the TULAA group than in the MLA group for IA. Mean postoperative hospital stay was shorter in the TULAA group for uncomplicated appendicitis. When the data of the EA group and the IA group were compared, operative time was significantly shorter in the IA group for both MLA and TULAA. The open conversion rate and the complication rate tended to be lower in the IA group. Confined to IA, the TULAA group tended to have shorter mean initial, postoperative, and total hospital stays. Conclusions: TULAA can be a useful surgical alternative to MLA in adults and young adolescents, because it lacks open conversion and provides both a shorter operative time and a shorter postoperative hospital stay. TULAA is feasible for IA in that it showed a lower rate of extended resection and complications.

scholarly journals Comparative study of single incision versus conventional three port laparoscopic appendectomy

2018 ◽  
Vol 5 (12) ◽  
pp. 3852 ◽  
Author(s):  
Sahil Rometra ◽  
Rahil Rometra ◽  
Neeraj Koul ◽  
R. K. Chrungoo
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Single Incision ◽  
Open Appendectomy ◽  
Single Incision Laparoscopic Surgery ◽  
Abdominal Incision ◽  
Significant Difference

Background: Appendicitis is primarily a disease of adolescents and young adults with a peak incidence in the second and third decades of life. Appendectomy for appendicitis is the most commonly performed emergency operation in the world.For more than a century, open appendectomy remained the gold standard for the treatment of acute appendicitis.  Laparoscopic surgery has become popular universally during the last couple of decades.   Efforts are still being made to decrease abdominal incision and visible scars after laparoscopy.  Single incision laparoscopic surgery (SILS) is a new innovation allowing minimal access surgery to be performed through a single umbilical incision.Methods: It was a prospective study carried out on 50 patients diagnosed as acute appendicitis. They were divided into two groups of 25 each. One group underwent Conventional Laparoscopic Appendectomy (CLA) and other group underwent Single Incision Laparoscopic Surgery (SILS).  Results were compared with regard to mean operative time,   complications, post-operative pain and discomfort (vas score at 12 hours), post-operative morbidity, duration of hospital stay and condition at discharge and cosmesis.Results: There was no statistically significant difference between the two groups with respect to the parameters like postoperative pain, hospital stay and complication profile. However, operative time for SILS appendectomy were found to be significantly higher compared to conventional group.Conclusions: Single incision laparoscopic appendectomy using standard laparoscopic instruments is safe and effective, feasible surgery with better cosmetic results.

Single-Incision Laparoscopic Appendectomy: An Early Experience

2011 ◽  
Vol 77 (3) ◽  
pp. 286-289 ◽  
Author(s):  
Elyssa J. Feinberg ◽  
David J. O'Connor ◽  
Michelle L. Feinberg ◽  
Pratiba Vemulapalli ◽  
Diego Camacho
Keyword(s):  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Single Incision ◽  
Intraoperative Complications ◽  
Early Experience ◽  
Demographic Characteristics ◽  
Postoperative Hospital Stay ◽  
General Surgeon ◽  
Laparoscopic Technique ◽  
Common Causes

Acute appendicitis is one of the most common causes of abdominal pain that a general surgeon will encounter. We describe our modification to the laparoscopic appendectomy: a single-incision laparoscopic (SILS) appendectomy completed entirely intracorporeally. From September 2008 to September 2009, a retrospective review of the electronic medical record was performed in all patients who underwent a SILS appendectomy to specifically analyze the demographic characteristics, time in the operating room to perform SILS appendectomy, length of postoperative hospital stay, and postoperative complications. Twenty-five patients underwent SILS appendectomy in the study period. There were 18 males and seven females with a mean age of 41 ± 15 years and mean body mass index of 26.5 ± 5 kg/m2. Single-incision laparoscopic appendectomy was performed successfully in all of our cases (100%). Mean operative time was 56 ± 16 minutes. Blood loss in all cases was minimal and there were no intraoperative complications. We successfully completed 25 appendectomies using the SILS method. Operative times were similar compared with the traditional laparoscopic technique. We believe that the SILS appendectomy is a safe and effective method that leaves a virtually invisible scar.

scholarly journals Laparoscopic repair of umbilical and paraumbilical hernias: a prospective and interventional study in government hospital

2019 ◽  
Vol 6 (9) ◽  
pp. 3283
Author(s):  
Kiren B. Patel ◽  
Mithun V. Barot
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Umbilical Hernia ◽  
Operative Time ◽  
Postoperative Hospital Stay ◽  
Site Infection ◽  
Drain Removal

Background: Umbilical and ventral hernia occurs as a result of weakness in musculofascial layer of anterior abdominal wall. The most important causes are congenital, acquired, incisional and traumatic. UH and VH can be repair by open surgical procedure. A successful series of laparoscopic repair of umbilical hernia and VH was done by Le blanc in 1993. The cost can be optimised by selection of mesh and optimal uses of transabdominal suture and various fixation devices. This original article reveals methods, techniques, indication, contraindication, post-op pain, operative time, surgical site infection recurrence and outcome of laparoscopic umbilical hernia and paraumbilical hernia repair.Methods: A total of 21 patients of ventral hernia (umbilical, paraumbilical and incisional), who underwent laparoscopic hernia repair from October 2014 to October 2016, were selected have taken part in study with valid consent, in B.J. Medical College Ahmedabad Gujarat. All patient study regarding operative time, postoperative pain, postoperative hospital stay, surgical site infection like wound infection, seroma, hernia defect size, mean drain removal and recurrence.Results: Out of 21 patients male are 33% and female are 67%. Mean age of patients is 45 yrs with range being 18-65 yrs. 28%, 33.33%, and 38.1% of patient had umbilical, paraumbilical and incisional hernia respectively. Mean size defect was 7.8 cm2. Mean operative time in this study is 98.6 minute. Mean drain removal is 2.80 day. Mean postoperative hospital stay was 3.3 days. 4.7% had wound infection, 9.5% had seroma formation. There is 0% recurrence in present study.Conclusions: The laparoscopic approach appears to be safe, effective and acceptable. It is also effective in those who are obese, with co morbidities (complex) and who have recurrence from prior open repair and having ascites.

scholarly journals Inappropriate manipulation and drainage exacerbate post-operative pain and prolong the hospital stay after laparoscopic appendectomy for pediatric complicated appendicitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi-Wen Tsai ◽  
Shin-Yi Lee ◽  
Jyun-Hong Jiang ◽  
Jiin-Haur Chuang
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Pediatric Patients ◽  
Complicated Appendicitis ◽  
Postoperative Hospital Stay ◽  
Postoperative Outcomes ◽  
Chang Gung Memorial Hospital ◽  
Abdominal Abscess ◽  
Penrose Drain ◽  
Drain Group

Abstract Background This study examined whether drain placement or not is associated with the postoperative outcomes of pediatric patients following trans-umbilical single-port laparoscopic appendectomy (TUSPLA) for complicated appendicitis. Methods The medical records of pediatric patients undergoing TUSPLA for acute complicated appendicitis from January 2012 to September 2018 in Kaohsiung Chang Gung Memorial Hospital were reviewed retrospectively. They were classified according to whether they received passive drainage with a Penrose drain (Penrose group) (19), active drainage with a Jackson-Pratt drain with a vacuum bulb (JP group) (16), or no drain (non-drain group) (86). The postoperative outcomes of the three groups were compared. Results Postoperative visual analog scale pain score was significantly higher in the non-drain group than in either the JP group or Penrose group. Patients in the Penrose group had a significantly longer postoperative hospital stay than those in the non-drain group and a higher rate of intra-abdominal abscess, while patients in the JP group had a significantly shorter postoperative hospital stay; moreover, no patient in JP group developed a postoperative intra-abdominal abscess. Conclusions Compared to passive drainage with a Penrose drain or no drain, active drainage with a JP drain shorter the postoperative hospital stay and decreased the risk of postoperative intra-abdominal abscess.

Minimization of Wound With the Assistance of a Needle Grasper in Single-Incision Laparoscopic Appendectomy

2019 ◽  
Vol 26 (5) ◽  
pp. 536-544
Author(s):  
Beom-Jin Kim ◽  
Jong Won Kim ◽  
Yoo Shin Choi ◽  
Yong Gum Park ◽  
Beom Gyu Kim ◽  
...  
Keyword(s):  
Laparoscopic Appendectomy ◽  
Medical Records ◽  
Operative Time ◽  
Single Incision ◽  
Pain Intensity Score ◽  
Short Term ◽  
Umbilical Incision ◽  
Telephone Interviews ◽  
Intensity Score ◽  
Glove Port

Background. Technical difficulties and pain from large wounds have prevented the widespread use of single-incision laparoscopic appendectomy (SILA). This study aimed to evaluate the efficacy of our newly developed needle grasper (Endo Relief)-assisted SILA (NASILA). Methods. For NASILA, about a 12-mm umbilical incision was made, and a glove port was introduced. A needle grasper was then introduced through a 2.5-mm wound on the suprapubic area. For SILA, a 2.5-cm transumbilical wound was made. The medical records of patients who underwent SILA or NASILA from June 2017 to September 2017 were retrospectively reviewed. Operative and short-term postoperative outcomes and results of telephone interviews for scars were compared. Results. A total of 49 patients in the SILA group (male: 40.8%) and 12 in the NASILA group (male: 50.0%) were included. Appendicitis status (not perforated:perforated without abscess:perforated with abscess) was significantly different between the 2 groups (SILA vs NASILA, 30:18:1 vs 4:6:2, P = .027). Additional trocars were inserted in 9 patients (18.4%) of the SILA group. The operative time was significantly shorter (43.3 ± 33.6 vs 54.1 ± 15.6 minutes, P = .012), and the highest numerical pain intensity score during the first 24 hours after surgery was significantly lower (2.4 ± 0.7 vs 3.0 ± 0.9, P = .038) in the NASILA group than in the SILA group. Hospital stay, postoperative complications, and complaint of scar were not significantly different between the 2 groups. Conclusions. NASILA was not inferior to SILA regarding cosmetic results. Operative convenience is higher in NASILA than in SILA, and the smaller surgical wound in NASILA minimizes postoperative pain.

Changes in Incidence and Management of Acute Appendicitis in Children—A Population-Based Study in the Period 2000–2015

2020 ◽  
Author(s):  
Grith Laerkholm Hansen ◽  
Jakob Kleif ◽  
Christian Jakobsen ◽  
Anders Paerregaard
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Pediatric Population ◽  
Open Appendectomy ◽  
Postoperative Mortality ◽  
Population Based ◽  
Postoperative Hospital Stay ◽  
Population Based Study ◽  
Registration System

Abstract Introduction Recent studies suggest that the epidemiology and management of appendicitis have changed during the last decades. The purpose of this population-based study was to examine this in the pediatric population in Denmark. Materials and Methods Data were retrieved from the Danish National Patient Registry, the Danish Civil Registration System, and the Statbank Denmark. Patients aged 0 to 17 years diagnosed with appendicitis and appendectomized during the period 2000 to 2015 were included. The primary outcome was the annual incidences of appendicitis. Secondary outcomes were the annual percent of patients with appendicitis having a laparoscopic appendectomy, delay from admission to surgery, length of postoperative hospital stay, and 30-day postoperative mortality. Results A total of 24,046 pediatric cases of appendicitis were identified. The annual incidence steadily declined until 2008 (–29%, all ages) and then remained stable. The surgical approach of choice changed from being open appendectomy in 2000 (97%) to laparoscopic appendectomy in 2015 (94%). Simultaneously, the duration of postoperative hospital stay declined from 41 hours (median) to 17 hours. Delay from admission until surgery did not change during the period. Only one child died within the 30-day postoperative period. Conclusion In accordance with other recent studies from Western countries, we found significant changes in the incidence of acute appendicitis including a decline in all age groups except those below 5 years of age, a shift toward laparoscopic appendectomy, and decreasing time spent in the hospital during the years 2000 to 2015.

scholarly journals Surgical strategy of empyema thoracis in children: open thoracotomy v/s video assisted thoracoscopy

2018 ◽  
Vol 5 (12) ◽  
pp. 3823
Author(s):  
Pranav Jadhav ◽  
Sanjay Raut ◽  
Manish Kumar Kashyap ◽  
Riddhi Ajay Bora
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Statistical Significance ◽  
Postoperative Hospital Stay ◽  
Empyema Thoracis ◽  
Open Thoracotomy ◽  
Appropriate Treatment ◽  
Estimated Blood Loss ◽  
Number Of Patients ◽  
Prolonged Air Leak

Background: Empyema is the suppuration within the pleural cavity, most commonly a complication of acute bacterial pneumonia. It is one of the most common diseases in children in India. Prognosis is excellent, provided appropriate treatment is administered early in the course of the disease.Methods: This study examines treatment of complex empyema thoracis between June 1, 2016, and April 30, 2018. Total number of patients were 30 cases in open thoracotomy and 30 in VATS in treatment of their disease. Effusion etiology was distributed as follows: infectious, neoplastic-associated, traumatic.Results: A total of 30 patients underwent VATS debridement and open thoracotomy for treatment of empyema thoracis. The median postoperative hospital stay was 10.31±3.751 days in case of VATS and 4.41±1.593 days in case of open thoracotomy. Median estimated blood loss in case of VATS was 78±15.634 ml and in case of open thoracotomy was 15.97±5.871 ml. Mean operative time was 82.86±17.293 minutes in case VATS and 77.59±13.38 minutes in case of open thoracotomy.Conclusions: VATS might be comparable or even better than open thoracotomy in terms of operative time, postoperative hospital stay, chest tube duration, prolonged air leak rate, morbidity and mortality. But referring to the relapse rate, there was no statistical significance.

scholarly journals Transumblical Single Incision Two-Port Laparoscopic Assisted Appendectomy: Early Experience in Paediatric Patients

2009 ◽  
Vol 22 (2) ◽  
pp. 289-294
Author(s):  
MA Nowshad ◽  
A Mostaque ◽  
SMA Shahid ◽  
HK Emrul
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Single Incision ◽  
Open Appendectomy ◽  
Operation Time ◽  
Randomized Controlled ◽  
Safe Technique ◽  
Port System ◽  
Laparoscopic Assisted ◽  
Additional Port

Laparoscopic appendectomy considered as superior alternative to open appendectomy. Usual laparoscopic appendectomy is performed with the three port system. In this study, we performed a unique single transumblical incision two-port laparoscopic assisted appendectomy with the aim to reduce postoperative port site complication as well as improving cosmesis and patients satisfaction. From January 2010, 32 patients were admitted with clinically diagnosed acute appendicitis and were randomly assigned to single transumblical incision two-port laparoscopic assisted appendectomy. Transumblical single incision two-port laparoscopic assisted appendectomy was attempted in all patients (9 males and 23 females) with an average age of 9.2 years. Transumblical single incision two-port laparoscopic assisted appendectomy was successfully completed in 31 patients. In one patient, another additional port required due to severe adhesion of the appendix. Mean operation time was 25.2 minutes (range, 17-38), and mean postoperative hospital stay was 1.Sdays (range 1-2). Postoperative complications (local pericaecal abscess) occurred in one case that was treated conservatively. Transumblical single incision two-port laparoscopic assisted appendectomy appears to be a feasible and safe technique for the treatment of acute appendicitis in the paediatric setting. It allows nearly scar less abdominal surgery. The true benefit of the technique should be assessed by randomized controlled trials.TAJ 2009; 22(1): 289-294

scholarly journals Modification of the Classical Percutaneous Extraperitoneal Procedure for Pediatric Inguinal Hernia to Reduce Complications: A Multiple-Centered Comparison Study

2021 ◽  
Author(s):  
Zhi-bin Luo ◽  
Jing-rong Tu ◽  
Hong-guang Shi ◽  
Zhi-yong Du ◽  
Xian-cai Xiang ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Adverse Events ◽  
Hospital Stay ◽  
Operative Time ◽  
Foreign Body Reaction ◽  
Postoperative Hospital Stay ◽  
Comparison Study ◽  
Pediatric Inguinal Hernia ◽  
Significant Difference ◽  
Safe Approach

Abstract Single-site laparoscopic percutaneous extraperitoneal ligation (SLPEL) for pediatric inguinal hernia gained popularity all over the world. However, complications associated with extraperitoneal knotting were not rare in the classical SLPEL(C-SLPEL) procedure. In order to overcome disadvantages, we herein developed the modified SLPEL (M-SLPEL) procedure, intact circuit ligation of the peritoneum around the internal ring using a homemade hernia needle with a single abdominal wall centesis. To evaluated the effectiveness of the M-SLPEL procedure to decrease adverse events associated with ligation knotting, a comparative study was carried out. A total of 3219 patients from multiple centers were divided into two groups according to the operative procedures: M-SLPEL group and C-SLPEL group. All patients were followed up. Data describing the clinical characteristics, operative time, postoperative hospital stay, and complications was collected and retrospectively analyzed. With equivalent operative time, postoperative hospital stay, there was statistically significant difference between two groups in terms of the overall complications incidence (2.6% in C-SLPEL Vs 0.11% in M-SLPEL, P=0.03), including pain in inguinal area, knot foreign body reaction, palpable knot, recurrence. Together, these findings suggest that the M-SLPEL procedure is an effective and safe approach, with unique advantage in reducing adverse events in the inguinal region.

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