BACKGROUND: To apply single-port trans-umbilical laparoscopic appendectomy (SPTULA) and to evaluate the effectiveness and safeness of this approach. METHOD: SPTULA address the association benefits from laparoscopic access with safety and simplicity from open appendectomy. We performed a retrospective analysis in 300 adolescents and adults with suspicion diagnosis of acute appendicitis. Single-port trans-umbilical laparoscopic appendectomy was the initial approach used in all patients from July 2001 through June 2006. The effectiveness of SPTULA was evaluated by considering surgery time, capacity of completeness, and necessity of conversion. The safeness was evaluated by the incidence of complications and mortality. RESULTS: Conversion for open or laparoscopic appendectomy was necessary in 9% of the cases. The main reasons for conversion were severe local inflammatory adhesions and advanced phases of acute appendicitis. The incidence of post-operative complications was 6.6%. Intra-abdominal abscess incidence was 1.3% and surgical site infection was 2.0%. There were no deaths. Histopathological examination confirmed 11.7% of advanced phases of acute appendicitis. CONCLUSION: SPTULA showed to be feasible, effective and safe. Results from this study and the attractiveness of this technique make this as the first choice for initial approach for adolescents and adults patients with suspicion diagnosis of acute appendicitis.
Appendicitis; Appendectomy; Laparoscopy; Video-assisted surgery
