A Single Site Approach to Appendicitis: A Review of a Single Center

Tsuji Yoshito, Nishizawa Yujiro, Ozato Yuki, Inoue Akira, Kagawa Yoshinori

doi:10.3862/jcoloproctology.77.161

<p>Laparoscopic appendicectomy was performed on 15,983 patients in 2021 in Japan, of whom only 2,598 (16.2%) underwent a single-site appendicectomy. In our center, the basic strategy for patients with appendicitis is to start with a single-site laparoscopic approach. Additional ports or ileocecal resection can be utilized depending on the intraoperative abdominal condition. In this study, we reviewed retrospectively the outcomes of the 85 consecutive patients, who underwent a single-site laparoscopic approach for appendicitis between April 2020 and March 2022 in our center.</p><p>The single-site approach was completed in 94% of patients. The final surgical procedures included appendicectomy in 68 cases (80%), partial cecal resection in 7 cases (8.2%), and ileocecal resection in 10 cases (11.8%). The median operative time was 79 minutes, and the median blood loss was 0 ml. Pathological inflammation status was gangrenous appendicitis in 37 cases, phlegmonous appendicitis in 34 cases, chronic appendicitis in 6 cases, and appendiceal diverticulitis in 3 cases. Postoperative complications were observed in 13 cases without Grade IIIb or higher complications (Clavien-Dindo classification). The median post-operative hospital stay was 5 days. The single-site approach is safe and feasible to allow intraoperative modification of the extended procedure according to the inflammation condition.</p>

A Single Site Approach to Appendicitis: A Review of a Single Center

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