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J Minim Access Surg. 2014 Jan;10(1):23-6. doi: 10.4103/0972-9941.124460.

Two-port laparoscopic appendectomy as transition to laparoendoscopic single site surgery.

Author information

1
Department of Surgery, Hospital Militar de Área de Porto Alegre, Rio Grande do Sul, Brazil ; Department of Surgery, Hospital de Clínicas, Federal University of Rio Grande do Sul State, Porto Alegre, Rio Grande do Sul, Brazil.
2
Department of Surgery, Hospital Militar de Área de Porto Alegre, Rio Grande do Sul, Brazil.
3
Institute of Education and Research, Hospital Moinhos de Vento de Porto Alegre, Rio Grande do Sul, Brazil.
4
Department of Surgery, Federal University of Amazonas State, Manaus, Amazonas, Brazil.
5
Department of Surgery, Hospital de Clínicas, Federal University of Rio Grande do Sul State, Porto Alegre, Rio Grande do Sul, Brazil.

Abstract

BACKGROUND:

According to the precepts of reduced surgical trauma and better cosmesis, an intermediate laparoscopic appendectomy technique between the conventional three-trocar procedure and Laparoendoscopic Single Site Surgery (LESS) was performed, based on literature review and experience of the surgical team.

PATIENTS AND METHODS:

Patients with early stage acute appendicitis and a favourable anatomical presentation were selected. The procedure was performed with two ports: A 10 mm trocar at the umbilicus site for laparoscope and a 5 mm one just above the pubic bone for grasper. The appendix was secured by external wire traction through a right iliac fossa puncture with 14-gauge intravenous catheter.

RESULTS:

From August 2009 to December 2012, we performed 42 cases; two required conversion to a conventional laparoscopic technique. There were no complications in the remaining, no wound infections and a mean operation time of 64.5 minutes.

CONCLUSION:

The use of two-port laparoscopic appendectomy can act as a LESS intermediate step procedure, without loss of instrumental triangulation and maintenance of appropriate counter-traction. This technique can be used as an alternative to the three-port laparoscopic procedure in patients with initial presentation of appendicitis and a favourable anatomical position.

KEYWORDS:

Appendix fixation; LESS; laparoscopic appendectomy; minimally invasive surgery

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