Transumbilical Single-Port Laparoscopic Appendectomy (TUSPLA): Scarless Intracorporeal Appendectomy

Background: Laparoscopic appendectomy is generally performed with the three-port system. In this study, we performed a unique single-port laparoscopic appendectomy, which we refer to as the transumbilical single-port laparoscopic appendectomy (TUSPLA). Methods: From April 19, 2008, 33 cases of TUSPLA were performed. A surgical glove was used as the "singleport" with an extra-small wound retractor, which was set up through a small umbilical incision. The surgical glove attached with one trocar and two pipes were then fixed to the outer ring of the wound retractor, which served as a single port with three working channels. Using this single-port system, TUSPLA was performed. The overall procedure was similar to that used for the three-port laparoscopic appendectomy. Results: TUSPLA was attempted in 33 patients (11 males and 22 females), with an average age of 31.2 years (range, 14-73). Average patient body mass index was 22.8kg/m(2) (range, 16.8-35.8). TUSPLA was successfully completed in 31 patients. In 2 cases, the operation was converted to the conventional three-port laparoscopic appendectomy due to a gangrenous change at the base of the appendix in 1 case and the need for drainage in another. Mean operation time was 40.8 minutes (range, 15-90), and mean postoperative hospital stay was 2.5 days (range, 1-11). Postoperative complications occurred in 3 cases; 2 cases were of localized pericecal abscess and 1 case was of omphalitis, and all were treated conservatively. Conclusion: TUSPLA is a safe, effective technique that allows nearly scarless abdominal surgery.